Healthcare Provider Details

I. General information

NPI: 1063990422
Provider Name (Legal Business Name): MORGAN MEDICAL SUPPLIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2018
Last Update Date: 07/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 MAIN ST
THOMSON GA
30824-2616
US

IV. Provider business mailing address

3210 PONDEROSA LN
THOMSON GA
30824-6605
US

V. Phone/Fax

Practice location:
  • Phone: 706-631-9305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN FRANKLIN SMITH II
Title or Position: PRESIDENT
Credential:
Phone: 706-631-9305