Healthcare Provider Details

I. General information

NPI: 1033044078
Provider Name (Legal Business Name): SHUJIAO GUI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 LOVES CHAPEL RD
GLENNVILLE GA
30427-1982
US

IV. Provider business mailing address

675 LOVES CHAPEL RD
GLENNVILLE GA
30427-1982
US

V. Phone/Fax

Practice location:
  • Phone: 978-584-2047
  • Fax:
Mailing address:
  • Phone: 978-584-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: GUI WALA
Title or Position: CEO
Credential:
Phone: 978-584-2047