Organization
CIVET HOLDINGS LLC
Active
Organization
CIVET HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OMAR GREEN (PRESIDENT)
(404) 433-7949
Entity
Organization
Contact information
Practice address
950 DANNON VW SW STE 4103, ATLANTA, GA 30331-2159
(404) 433-7949
Mailing address
2549 LAQUANDA CT SW, ATLANTA, GA 30331-7890
(404) 433-7949
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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