Organization
OMNIMED MEDICAL SUPPLY AND EQUIPMENT L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGERS FULCHER GOTIER II (CEO)
(770) 648-8622
Entity
Organization
Contact information
Practice address
3113 EDINBURGH CT, CONYERS, GA 30094-6863
(770) 648-8622
Mailing address
927 COMMERCIAL ST NE, CONYERS, GA 30012-4537
(770) 648-8622
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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