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General NPI Number Information
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NPI Number | 1275773921
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL MEDICAL SYSTEMS, LLC
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 904 CENTER ST NE
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City | CONYERS
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State | GA
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Zip | 30012-4536
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Country | US
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Telephone | 770-785-9201
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Fax | 770-602-1603
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Provider Business Mailing Address
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Address Line | 904 CENTER ST NE
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City | CONYERS
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State | GA
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Zip | 30012-4536
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Country | US
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Telephone | 770-785-9201
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Fax | 770-602-1603
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Authorized Official
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Title or Position | CEO
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Name | ROBERT D REDDING
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Credential |
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Telephone | 770-785-9201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State |
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