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General NPI Number Information
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NPI Number | 1346155058
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Entity Type | Organization
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Legal Business Name | GEORGE MED SUPPLY
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 2450 CAMELLIA LN NE APT 1428
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City | ATLANTA
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State | GA
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Zip | 30324-6293
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Country | US
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Telephone | 943-204-7580
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Fax |
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Provider Business Mailing Address
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Address Line | 7742 SPALDING DR # 386
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City | NORCROSS
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State | GA
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Zip | 30092-4207
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Country | US
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Telephone | 943-204-7580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HARICHARANTEJA MADDURI
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Credential |
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Telephone | 943-204-7580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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