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General NPI Number Information
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NPI Number | 1104349695
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Entity Type | Organization
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Legal Business Name | ASCEND DME, LLC
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 07/17/2017
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Provider Practice Location Address
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Address Line | 2304 RESERVE DR NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-5908
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Country | US
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Telephone | 770-894-1778
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Fax |
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Provider Business Mailing Address
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Address Line | 3152 CORNER OAK DR
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30071-1511
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Country | US
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Telephone | 770-894-1778
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. KARINA BAKER
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Credential |
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Telephone | 770-894-1778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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