Organization
IB MEDSUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INNA GENDLER (OWNER)
(770) 650-4625
Entity
Organization
Contact information
Practice address
5040 LAKE FJORD PASS, MARIETTA, GA 30068-1640
(770) 650-4625
(770) 650-4625
Mailing address
5040 LAKE FJORD PASS, MARIETTA, GA 30068-1640
(770) 650-4625
(770) 650-4625
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00745324A
—
GA
Enumeration date
12/16/2005
Last updated
08/22/2020
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