Healthcare Provider Details

I. General information

NPI: 1801957964
Provider Name (Legal Business Name): GEORGIA MEDICAL SUPPLY OF RICHLAND , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4454 WARM SPRINGS RD STE D3
COLUMBUS GA
31909-5992
US

IV. Provider business mailing address

PO BOX 550309
BIRMINGHAM AL
35255-0309
US

V. Phone/Fax

Practice location:
  • Phone: 229-887-0039
  • Fax: 229-887-0040
Mailing address:
  • Phone: 205-566-1674
  • Fax: 205-278-6900

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. LONNIE BLAKE DORCEY
Title or Position: PRESIDENT
Credential:
Phone: 205-566-1674