Organization
GUADALUPE MEDINA PTR FUTURE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUADALUPE MEDINA (OWNER)
(770) 442-0050
Entity
Organization
Contact information
Practice address
5670 ATLANTA HWY, STE B, ALPHARETTA, GA 30004-5903
(770) 442-0050
(770) 442-0225
Mailing address
5670 ATLANTA HWY, STE B, ALPHARETTA, GA 30004-5903
(770) 442-0050
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
L20062933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154777
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
04/20/2008
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