Organization
TRIAD MEDICAL ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AL TURNER (REGISTERED MANAGER)
(229) 244-4811
Entity
Organization
Contact information
Practice address
3790 OLD US HIGHWAY 41 N STE C, SUITE C, VALDOSTA, GA 31602-6867
(229) 241-8811
Mailing address
3790 OLD US HIGHWAY 41 N STE C, SUITE C, VALDOSTA, GA 31602-6867
(229) 241-8811
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
O-007058
GA
332BC3200X
Customized Equipment (DME)
O-007058
GA
332BX2000X
Oxygen Equipment & Supplies (DME)
O-007058
GA
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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