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Organization
DAVID PETSCH ENTERPRISES, INC.
Active
Organization
DAVID PETSCH ENTERPRISES, INC.
Active
Other names
Petsch Respiratory Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHADWICK KEEBLE MCCRICKARD (PRESIDENT)
(706) 863-6252
Entity
Organization
Contact information
Practice address
3845 MARTINEZ BLVD, MARTINEZ, GA 30907-2666
(706) 863-6252
(706) 863-2337
Mailing address
3845 MARTINEZ BLVD, MARTINEZ, GA 30907-2666
(706) 863-6252
(706) 863-2337
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
20012830780
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00850726A
—
GA
05
—
DE1565
—
SC
Enumeration date
09/12/2005
Last updated
06/11/2021
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