Healthcare Provider Details

I. General information

NPI: 1669768081
Provider Name (Legal Business Name): MR. NEB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5076 WINTERS CHAPEL RD STE 200
ATLANTA GA
30360-1832
US

IV. Provider business mailing address

PO BOX 922189
NORCROSS GA
30010-2189
US

V. Phone/Fax

Practice location:
  • Phone: 770-394-5330
  • Fax: 770-394-5332
Mailing address:
  • Phone: 866-449-4784
  • Fax: 888-835-3354

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0275
License Number StateGU

VIII. Authorized Official

Name: SUE ELLEN KAY
Title or Position: SR VICE PRESIDENT
Credential:
Phone: 888-588-9630