Healthcare Provider Details

I. General information

NPI: 1598856890
Provider Name (Legal Business Name): SPALDING MEDICAL PRODUCTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 S 8TH ST
GRIFFIN GA
30224-4212
US

IV. Provider business mailing address

504 S 8TH ST
GRIFFIN GA
30224-4212
US

V. Phone/Fax

Practice location:
  • Phone: 770-228-2793
  • Fax: 770-228-8047
Mailing address:
  • Phone: 770-228-2793
  • Fax: 770-228-8047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number3720250001
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE005101
License Number StateGA

VIII. Authorized Official

Name: MR. JOHN EDWARD TUCKER
Title or Position: CEO
Credential: R.PH.
Phone: 770-228-2793