Organization
DAVID PETSCH ENTERPRISES, INC.
Active
Other names
Petsch Respiratory Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHADWICK KEEBLE MCCRICKARD (PRESIDENT)
(706) 863-6252
Entity
Organization
Contact information
Practice address
3845 MARTINEZ BLVD, MARTINEZ, GA 30907-2666
(706) 863-6252
(706) 863-2337
Mailing address
3845 MARTINEZ BLVD, MARTINEZ, GA 30907-2666
(706) 863-6252
(706) 863-2337
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
20012830780
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00850726A
—
GA
05
—
DE1565
—
SC
Enumeration date
09/12/2005
Last updated
06/11/2021
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