Organization
TEDDER MEDICAL LLC
Active
Organization
TEDDER MEDICAL LLC
Active
Other names
Tedder Medical LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HAMPTON TEDDER DME (OWNER)
(334) 524-6589
Entity
Organization
Contact information
Practice address
3928 LANDMARK DR, DOUGLASVILLE, GA 30135-1290
Mailing address
3928 LANDMARK DR, DOUGLASVILLE, GA 30135-1290
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053952226
TEDDER MEDICAL LLC S CORP NPI
GA
Enumeration date
10/29/2019
Last updated
11/21/2019
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