Healthcare Provider Details

I. General information

NPI: 1477552214
Provider Name (Legal Business Name): USA MEDICAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3316 PERKINS RD
AUGUSTA GA
30906-3814
US

IV. Provider business mailing address

3316 PERKINS RD
AUGUSTA GA
30906-3814
US

V. Phone/Fax

Practice location:
  • Phone: 706-798-7950
  • Fax: 706-798-7656
Mailing address:
  • Phone: 706-798-7950
  • Fax: 706-798-7656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. WALLACE B CASSELS
Title or Position: PRESIDENT
Credential:
Phone: 706-798-7950