Healthcare Provider Details

I. General information

NPI: 1225366891
Provider Name (Legal Business Name): GIRAFFE ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 TOWN PARK BLVD STE 1 B
EVANS GA
30809-3471
US

IV. Provider business mailing address

PO BOX 3103
EVANS GA
30809-0079
US

V. Phone/Fax

Practice location:
  • Phone: 706-832-2926
  • Fax: 804-675-0497
Mailing address:
  • Phone: 706-832-2926
  • Fax: 804-675-0497

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: BETH BAILEY
Title or Position: OWNER
Credential:
Phone: 804-675-4550