Organization
BENCOR MEDICAL LLC
Active
Other names
Southeastern Neb Pros
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN R HUSS (PRESIDENT)
(770) 601-9199
Entity
Organization
Contact information
Practice address
4210 COLUMBIA RD, BLDG 6, MARTINEZ, GA 30907-0401
(800) 620-6327
(706) 869-7229
Mailing address
4210 COLUMBIA RD, BLDG 6, MARTINEZ, GA 30907-0401
(800) 620-6327
(706) 869-7229
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040918183A
—
GA
05
—
DE2533
—
SC
Enumeration date
12/22/2005
Last updated
05/21/2010
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