Organization
PEACHTREE MEDICAL SUPPLY LLC
Active
Organization
PEACHTREE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZUKA ILOH (MANAGER)
(908) 447-2665
Entity
Organization
Contact information
Practice address
3050 STATE ST, PEACHTREE CITY, GA 30269-1598
(678) 829-3366
Mailing address
3050 STATE ST, PEACHTREE CITY, GA 30269-1598
(678) 829-3366
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/01/2023
Last updated
03/23/2024
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