Organization
KENNESAW MEDICAL SUPPLY
Active
Organization
KENNESAW MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIOVANNA TAMARA HERNANDEZ (OWNER)
(770) 974-6797
Entity
Organization
Contact information
Practice address
3600 CHEROKEE ST NW, SUITE 120, KENNESAW, GA 30144-2027
(770) 425-8709
(770) 425-8744
Mailing address
3600 CHEROKEE ST NW, SUITE 120, KENNESAW, GA 30144-2027
(770) 425-8709
(770) 425-8744
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/13/2007
Last updated
08/12/2008
Update your record
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