Organization
BANDE ENTERPRISES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DELBERT LEWIN CARROLL PHD (VICE PRESIDENT OPERATIONS)
(770) 460-0612
Entity
Organization
Contact information
Practice address
130 INDUSTRIAL WAY, FAYETTEVILLE, GA 30215-6814
(770) 460-0612
(770) 460-5114
Mailing address
130 INDUSTRIAL WAY, FAYETTEVILLE, GA 30215-6814
(770) 460-0612
(770) 460-5114
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00272731A
—
GA
Enumeration date
01/19/2006
Last updated
08/22/2020
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