Organization
DIANE RAULERSONS HOME MEDICAL EQUIPMENT
Active
Other names
A Plus Home Oxygen & Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE P RAULERSON RN (OWNER)
(912) 283-4663
Entity
Organization
Contact information
Practice address
2019 ALICE ST, WAYCROSS, GA 31501-6209
(912) 283-4663
(912) 338-0208
Mailing address
2019 ALICE ST, WAYCROSS, GA 31501-6209
(912) 283-4663
(912) 338-0208
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
002687
GA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
002687
GA
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
002687
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00855357A
—
GA
Enumeration date
02/27/2007
Last updated
03/22/2012
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