Organization
COMPLETE MEDICAL SUPPLY&EQUIPMENT;LLC
Active
Organization
COMPLETE MEDICAL SUPPLY&EQUIPMENT;LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSEY UDOM (MANAGER)
(678) 213-1055
Entity
Organization
Contact information
Practice address
6116 MABLETON PKWY SW STE 128, MABLETON, GA 30126-4305
(678) 213-1055
(678) 213-1056
Mailing address
PO BOX 1333, LITHIA SPRINGS, GA 30122-1166
(678) 213-1055
(678) 213-1056
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20100038403
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
631317089A
—
GA
Enumeration date
07/29/2005
Last updated
11/09/2023
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