Healthcare Provider Details

I. General information

NPI: 1982607222
Provider Name (Legal Business Name): MEDICAL AID SUPPLY HOUSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 PEACHTREE INDUSTRIAL BLVD STE 980
DULUTH GA
30096-6506
US

IV. Provider business mailing address

3455 PEACHTREE INDUSTRIAL BLVD STE 980
DULUTH GA
30096-6506
US

V. Phone/Fax

Practice location:
  • Phone: 770-622-1211
  • Fax:
Mailing address:
  • Phone: 770-622-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberC21507
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateGA

VIII. Authorized Official

Name: JEONG HEE WOO
Title or Position: PRESIDENT/CEO
Credential:
Phone: 770-622-1211