Organization
MAIN STREET DME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON YURI ONOUFRIENKO (OWNER)
(678) 387-5620
Entity
Organization
Contact information
Practice address
2959 CHEROKEE ST NW STE 103C, KENNESAW, GA 30144-6522
(678) 387-5620
(678) 638-2857
Mailing address
2959 CHEROKEE ST NW STE 103C, KENNESAW, GA 30144-6522
(678) 387-5620
(678) 638-2857
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/14/2023
Last updated
02/08/2024
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