Organization
BLUE WAVE MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAMARR DIXON (OWNER)
(404) 759-3594
Entity
Organization
Contact information
Practice address
388 BAYWOOD WAY, HIRAM, GA 30141-4122
(404) 759-3594
Mailing address
388 BAYWOOD WAY, HIRAM, GA 30141-4122
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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