Organization
MG MEDICAL EQUIPMENT AND SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LARRY WATERS (CEO)
(770) 490-3911
Entity
Organization
Contact information
Practice address
660 E CHURCH ST STE A, JASPER, GA 30143-1312
(770) 490-3911
(678) 823-7129
Mailing address
660 E CHURCH ST STE A, JASPER, GA 30143-1312
(770) 490-3911
(678) 823-7129
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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