Organization
SOUTHEASTERN SCIENTIFIC SUPPLY COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BRAIN (OWNER/GM)
(770) 913-8768
Entity
Organization
Contact information
Practice address
6883 JUSTIN DR, LOGANVILLE, GA 30052-6401
(770) 913-8768
(770) 913-8762
Mailing address
6883 JUSTIN DR, LOGANVILLE, GA 30052-6401
(770) 913-8768
(770) 913-8762
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
20113603522
GA
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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