Healthcare Provider Details

I. General information

NPI: 1568728111
Provider Name (Legal Business Name): AURILINK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 CHEROKEE ST NE SUITE 9
MARIETTA GA
30060-8964
US

IV. Provider business mailing address

627 CHEROKEE ST NE SUITE 9
MARIETTA GA
30060-8964
US

V. Phone/Fax

Practice location:
  • Phone: 770-590-8662
  • Fax: 770-424-2099
Mailing address:
  • Phone: 770-590-8662
  • Fax: 770-424-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberHADE000439
License Number StateGA

VIII. Authorized Official

Name: MR. OTIS A. WHITCOMB
Title or Position: OWNER
Credential: MASTER OF ARTS
Phone: 770-590-8662