Healthcare Provider Details

I. General information

NPI: 1053626416
Provider Name (Legal Business Name): S2 MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 02/20/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 SUGARLOAF PKWY STE 300
DULUTH GA
30097-4359
US

IV. Provider business mailing address

2780 PEACHTREE INDUSTRIAL BLVD STE C
DULUTH GA
30097-7910
US

V. Phone/Fax

Practice location:
  • Phone: 678-824-6290
  • Fax: 678-824-6296
Mailing address:
  • Phone: 678-824-6290
  • Fax: 678-824-6296

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 Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: REBECCA MCGREGOR
Title or Position: PARTNER
Credential:
Phone: 678-824-6290