MEDICARE: PEACHTREE RAPIDCARE MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1881549947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACHTREE RAPIDCARE MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	6825 JIMMY CARTER BLVD STE 1220K
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30071-1228
Country	:	US
Telephone Number	:	470-797-6566
Fax Number	:

Provider Business Practice Location Address
First Line	:	6825 JIMMY CARTER BLVD STE 1220K
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30071-1228
Country	:	US
Telephone Number	:	470-797-6566
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAHITH DEVATHI
Credential	:
Telephone Number	:	470-797-6566

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	06/03/2026

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