Organization
ABAGAN MEDICAL SUPPLIES
Active
Organization
ABAGAN MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EKONG A UMOREN (C.E.O.)
(770) 621-3090
Entity
Organization
Contact information
Practice address
2179 NORTHLAKE PKWY STE 20, TUCKER, GA 30084-4106
(770) 621-3090
(770) 621-3091
Mailing address
2179 NORTHLAKE PKWY STE 20, TUCKER, GA 30084-4106
(770) 621-3090
(770) 621-3091
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
08004787
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00201800
STATE
GA
01
—
6051790002
DME SUPPLIER NUMBER
GA
Enumeration date
01/22/2008
Last updated
04/10/2009
Update your record
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