Organization
EASTSIDE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATORIUS MCCRAY (OWNER)
(678) 768-4318
Entity
Organization
Contact information
Practice address
1016 BALTIC WAY, LITHONIA, GA 30058-5968
(678) 768-4318
Mailing address
7162 LONE OAK WAY, LITHONIA, GA 30058-8291
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/08/2021
Last updated
07/09/2021
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