Healthcare Provider Details

I. General information

NPI: 1467757492
Provider Name (Legal Business Name): HEAD-TO-TOE MEDICAL SUPPLIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3886 PRINCETON LAKES WAY SW SUITE 140-B
ATLANTA GA
30331-5511
US

IV. Provider business mailing address

3886 PRINCETON LAKES WAY SW SUITE 140-B
ATLANTA GA
30331-5511
US

V. Phone/Fax

Practice location:
  • Phone: 770-745-4224
  • Fax: 404-844-4930
Mailing address:
  • Phone: 770-745-4224
  • Fax: 404-844-4930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. QUINCY EARL SNEED
Title or Position: CEO/PRESIDENT
Credential:
Phone: 404-593-6646