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General NPI Number Information
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NPI Number | 1417933631
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Entity Type | Organization
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Legal Business Name | EDDIE TEST MEDICAL EQUIPMENT INC
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 55 GENERAL CLEBURNE STREET
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City | RINGGOLD
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State | GA
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Zip | 30736
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Country | US
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Telephone | 706-965-8378
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Fax | 706-965-6672
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Provider Business Mailing Address
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Address Line | 55 GENERAL CLEBURNE STREET
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City | RINGGOLD
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State | GA
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Zip | 30736
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Country | US
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Telephone | 706-965-8378
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Fax | 706-965-6672
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Authorized Official
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Title or Position | OWNER
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Name | EDDIE TEST
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Credential |
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Telephone | 706-965-8378
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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 | 20006035684
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License Number State | GA
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