Organization
KING 1959, INC.
Active
Organization
KING 1959, INC.
Active
Other names
Diabetic Relief
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SHANNON THOMAS (CEO)
(770) 689-9788
Entity
Organization
Contact information
Practice address
2055 GEES MILL RD NE STE 313, CONYERS, GA 30013-1363
(770) 689-9788
Mailing address
4002 HIGHWAY 78 W # 530-242, SNELLVILLE, GA 30039-7915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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