Organization
DURABLE MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMON OROBOR (DIRECTOR)
(770) 719-9998
Entity
Organization
Contact information
Practice address
720 GLYNN ST N, #D-1, FAYETTEVILLE, GA 30214-6706
(770) 719-9998
(770) 719-9970
Mailing address
720 GLYNN ST N STE D1, FAYETTEVILLE, GA 30214-6706
(770) 719-9998
(770) 719-9970
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
302613978
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
932368359A
—
GA
Enumeration date
12/29/2005
Last updated
05/01/2018
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