Healthcare Provider Details

I. General information

NPI: 1417674268
Provider Name (Legal Business Name): RED ONE MEDICAL DEVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 E OGLETHORPE AVE STE G
SAVANNAH GA
31401-4141
US

IV. Provider business mailing address

513 E OGLETHORPE AVE STE G
SAVANNAH GA
31401-4141
US

V. Phone/Fax

Practice location:
  • Phone: 912-662-1443
  • Fax: 912-662-1447
Mailing address:
  • Phone: 912-662-1443
  • Fax: 912-662-1447

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES POLLAK
Title or Position: PRESIDENT & CEO
Credential:
Phone: 917-582-1904