Organization
MEDLIFE MEDICAL SUPPLY LLC
Active
Organization
MEDLIFE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH B SMITH (OWNER GENERAL MANAGER)
(770) 908-5666
Entity
Organization
Contact information
Practice address
2191 NORTHLAKE PKWY, SUITE-J BLDG #11, TUCKER, GA 30084-4166
(770) 908-5666
(770) 908-5675
Mailing address
2191 NORTHLAKE PKWY, SUITE-J BLDG #11, TUCKER, GA 30084-4166
(770) 908-5666
(770) 908-5675
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20020660338
GA
Other
Enumeration date
02/29/2008
Last updated
06/20/2008
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