Organization
NRC MEDICALS SUPPLIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY TIPTON KWAKUMEY (OWNER)
(678) 985-1989
Entity
Organization
Contact information
Practice address
368 W PIKE ST, SUITE 204 B, LAWRENCEVILLE, GA 30045-3240
(678) 985-1989
(770) 755-5682
Mailing address
368 W PIKE ST, SUITE 204 B, LAWRENCEVILLE, GA 30045-3240
(678) 985-1989
(770) 755-5682
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20019192637
GA
Other
Enumeration date
05/15/2007
Last updated
08/22/2020
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