Organization
MR NEB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN GAVIN (MANAGING PARTNER)
(770) 614-0994
Entity
Organization
Contact information
Practice address
1085 PARKWAY INDUSTRIAL PARK DR, SUITE B, BUFORD, GA 30518-1644
(770) 614-0994
(770) 614-8818
Mailing address
1085 PARKWAY INDUSTRIAL PARK DR, SUITE B, BUFORD, GA 30518-1644
(770) 614-0994
(770) 614-8818
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52000392
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/10/2006
Last updated
08/22/2020
About Stedi
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