Organization
TRIAD MEDICAL SUPPLY LLC
Active
Other names
dba INFU-CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROLLYNE KLEM RN, CRNI, OCN (PRESIDENT/CEO)
(678) 762-1520
Entity
Organization
Contact information
Practice address
360 WINKLER DR STE F, ALPHARETTA, GA 30004-0764
(601) 605-1699
(800) 511-1137
Mailing address
360 WINKLER DR STE F, ALPHARETTA, GA 30004-0764
(601) 605-1699
(800) 511-1137
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
06771-11.1
MS
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
06771/11.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07806820
—
MS
01
—
1030137
ACM
MS
01
—
611626100
ACS
MS
Enumeration date
12/11/2006
Last updated
03/13/2014
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