Eagle Sportschairs LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

2009018070 Issued in GA

Legal business name

EAGLE SPORTSCHAIRS LLC

Practice address

2351 Parkwood Rd
Snellville, GA 30039-4003

Phone

(770) 972-0763

Fax

(770) 985-4885

NPI assigned

Jul 6, 2009

Last updated

Jul 6, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Barry M Ewing

Title

Owner

Phone

(770) 972-0763

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1891924353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 PARKWOOD RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30039",
            "telephone_number": "770-972-0763",
            "fax_number": "770-985-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 PARKWOOD RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394003",
            "telephone_number": "770-972-0763",
            "fax_number": "770-985-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE SPORTSCHAIRS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "EWING",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-972-0763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "2009018070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Snellville, GA
• Providers in Snellville, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.