Organization
MEDIQUIP REHABILITATIVE EQUIPMENT AND SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI R JORDAN (CEO)
(404) 362-9855
Entity
Organization
Contact information
Practice address
2084 REX RD, SUITE 3, LAKE CITY, GA 30260-3960
(404) 362-9855
(404) 362-9856
Mailing address
2084 REX RD, SUITE 3, LAKE CITY, GA 30260-3960
(404) 362-9855
(404) 362-9856
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/06/2007
Last updated
04/07/2010
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