Organization
GEORGIA STATE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MALINDA WALLER (OWNER)
(678) 974-5866
Entity
Organization
Contact information
Practice address
1841 PEACHTREE RD NE, ATLANTA, GA 30309-1524
(678) 974-5866
(678) 974-5861
Mailing address
1841 PEACHTREE RD NE, ATLANTA, GA 30309-1524
(678) 974-5866
(678) 974-5861
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/11/2012
Last updated
11/20/2013
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