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Organization

TOCCOA CLINIC MEDICAL ASSOC

Active
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Organization

TOCCOA CLINIC MEDICAL ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAY BRUELAND (BUSINESS DIRECTOR)
(706) 886-7537
Entity
Organization

Contact information

Practice address
274 BIG A ROAD, TOCCOA, GA 30577-6002
(706) 886-7537
Mailing address
PO BOX 2153, DEPT 3423, BIRMINGHAM, AL 35287-3423

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0835590001
MEDICARE DME SUPPLIER NUM
GA
Enumeration date
07/31/2007
Last updated
11/17/2022
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