Organization
SRG INC
Active
Organization
SRG INC
Active
Other names
SPORTAID/MEDAID
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY RENEE GREEN (PRESIDENT)
(770) 554-5033
Entity
Organization
Contact information
Practice address
78 BAY CREEK RD, LOGANVILLE, GA 30052-7398
(770) 554-5033
(770) 554-5944
Mailing address
78 BAY CREEK RD, LOGANVILLE, GA 30052-7398
(770) 554-5033
(770) 554-5944
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/15/2006
Last updated
08/22/2020
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