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PHASES MEDICAL EQUIPMENT AND SUPPLIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MESHALL PETTEWAY (CEO)
(404) 675-9100
Entity
Organization

Contact information

Practice address
4930 GOVERNORS DR, 409, FOREST PARK, GA 30297-6101
(404) 675-9100
(404) 675-9102
Mailing address
4930 GOVERNORS DR, 409, FOREST PARK, GA 30297-6101
(404) 675-9100
(404) 675-9102

Taxonomy

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

Other

Enumeration date
06/12/2010
Last updated
07/21/2022
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