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General NPI Number Information
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NPI Number | 1720070709
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Entity Type | Organization
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Legal Business Name | CARE MEDICAL OF GEORGIA
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 1572 HIGHWAY 85N SUITE 505
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7729
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Country | US
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Telephone | 678-228-2849
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Fax | 678-228-1636
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Provider Business Mailing Address
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Address Line | 1572 HIGHWAY 85N SUITE 505
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7729
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Country | US
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Telephone | 678-228-2849
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Fax | 678-228-1636
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Authorized Official
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Title or Position | MANAGEMENT
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Name | MS. TANDRA DAVIS PHILLIPS
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Credential |
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Telephone | 404-468-5903
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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 |
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License Number State | GA
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