Organization
MY IDEAL CARE, LLC
Active
Organization
MY IDEAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADRIAN PAUL DAVIS (OWNER)
(229) 236-0197
Entity
Organization
Contact information
Practice address
218 W JACKSON ST, THOMASVILLE, GA 31792-5491
(229) 236-0197
(229) 255-2930
Mailing address
218 W JACKSON ST, THOMASVILLE, GA 31792-5491
(229) 236-0197
(229) 255-2930
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129741
—
AL
01
—
1346545274
TRICARE SOUTH REGION
GA
Enumeration date
01/25/2011
Last updated
07/26/2011
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