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General NPI Number Information
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NPI Number | 1548217789
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Entity Type | Organization
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Legal Business Name | CONSOLIDATED CRITICAL CARE, INC.
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 1035 RESEARCH CENTER ATLANTA DR SW SUITE A
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City | ATLANTA
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State | GA
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Zip | 30331-2035
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Country | US
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Telephone | 404-699-5559
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Fax | 404-699-5535
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Provider Business Mailing Address
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Address Line | 1035 RESEARCH CENTER ATLANTA DR SW SUITE A
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City | ATLANTA
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State | GA
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Zip | 30331-2035
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Country | US
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Telephone | 404-699-5559
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Fax | 404-699-5535
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD VANNOY
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Credential |
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Telephone | 404-699-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 060172139
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License Number State | GA
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