Organization
FOREVER ACTIVE MEDICAL, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT JASON PAUL (PRESIDENT)
(770) 642-9191
Entity
Organization
Contact information
Practice address
2852 JOHNSON FERRY RD, SUITE 200, MARIETTA, GA 30062-5686
(770) 642-9191
(770) 642-1580
Mailing address
2852 JOHNSON FERRY RD, SUITE 200, MARIETTA, GA 30062-5686
(770) 642-9191
(770) 642-1580
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/29/2008
Last updated
10/03/2008
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