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Organization

MEDIQUIP MEDICAL SUPPLIES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PRISCILLA WATT (CEO)
(770) 498-7077
Entity
Organization

Contact information

Practice address
4404 HUGH HOWELL RD, SUITE 21, TUCKER, GA 30084-5996
(770) 270-5808
Mailing address
4404 HUGH HOWELL ROAD, SUITE 21, TUCKER, GA 30084-5996
(770) 270-5808

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
133568
GA
335E00000X
Prosthetic/Orthotic Supplier
133568
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000885684A
GA
Enumeration date
11/03/2006
Last updated
10/16/2008
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