Healthcare Provider Details

I. General information

NPI: 1427077627
Provider Name (Legal Business Name): A D MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N WESTOVER BLVD STE B
ALBANY GA
31707-2900
US

IV. Provider business mailing address

202 N WESTOVER BLVD STE B
ALBANY GA
31707-2900
US

V. Phone/Fax

Practice location:
  • Phone: 229-420-8890
  • Fax: 229-639-0081
Mailing address:
  • Phone: 229-420-8890
  • Fax: 229-639-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVIS W KING SR.
Title or Position: PRESIDENT
Credential:
Phone: 229-639-0021