Healthcare Provider Details

I. General information

NPI: 1669886529
Provider Name (Legal Business Name): RYU MEDICAL USA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3775 VENTURE DR BLDG N-202
DULUTH GA
30096-5102
US

IV. Provider business mailing address

3775 VENTURE DR BLDG N-202
DULUTH GA
30096-5102
US

V. Phone/Fax

Practice location:
  • Phone: 678-514-0648
  • Fax: 770-817-6139
Mailing address:
  • Phone: 678-514-0648
  • Fax: 770-817-6139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number2014013941
License Number StateGA

VIII. Authorized Official

Name: MARCELL CHUN
Title or Position: GENERAL MANAGER
Credential:
Phone: 770-827-9801