Healthcare Provider Details

I. General information

NPI: 1316087760
Provider Name (Legal Business Name): MEDEQUIP PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 CENTERVILLE HWY SUITE 103
SNELLVILLE GA
30039-6405
US

IV. Provider business mailing address

3555 CENTERVILLE HWY SUITE 103
SNELLVILLE GA
30039-6405
US

V. Phone/Fax

Practice location:
  • Phone: 404-561-3593
  • Fax: 770-985-9229
Mailing address:
  • Phone: 404-561-3593
  • Fax: 770-985-9229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. TED WILLIS
Title or Position: PRESIDENT
Credential:
Phone: 404-561-3593