=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184713216
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DUNAMIS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3545 CRUSE RD. SUITE 312
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30044-3171
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-279-1144
-----------------------------------------------------
Fax | 770-279-0809
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3545 CRUSE RD SUITE 312
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30044-3170
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-279-1144
-----------------------------------------------------
Fax | 770-279-0809
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RICHARD B SATTERFIELD JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 770-279-1144
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number | 2006015905
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------