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General NPI Number Information
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NPI Number | 1629915954
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Entity Type | Organization
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Legal Business Name | ARES MEDICAL GROUP
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 6106 COCA COLA BLVD STE B
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City | COLUMBUS
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State | GA
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Zip | 31909-5705
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Country | US
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Telephone | 706-392-3905
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Fax |
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Provider Business Mailing Address
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Address Line | 6106 COCA COLA BLVD STE B
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City | COLUMBUS
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State | GA
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Zip | 31909-5705
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Country | US
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Telephone | 706-392-3905
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEREMY ILILAU
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Credential | ILILAU
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Telephone | 706-392-3905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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