Organization
MEDEQUIP INC
Active
Organization
MEDEQUIP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA C BOSTICK MBA (OWNER/OPERATOR)
(678) 620-1147
Entity
Organization
Contact information
Practice address
3554 MCINTOSH LANE, SNELLVILLE, GA 30039-4840
(678) 620-1147
Mailing address
3554 MCINTOSH LANE, SNELLVILLE, GA 30039-4840
(678) 620-1147
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20533269
EIN
GA
Enumeration date
10/02/2006
Last updated
08/22/2020
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