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General NPI Number Information
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NPI Number | 1760338826
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Entity Type | Organization
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Legal Business Name | COSMO COURT LLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 965 OAKLAND RD STE 2E
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3758
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Country | US
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Telephone | 678-656-7469
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Fax |
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Provider Business Mailing Address
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Address Line | 4850 SUGARLOAF PKWY STE 209
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-2868
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Country | US
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Telephone | 678-656-7469
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | COURTNEY WALKER
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Credential | COSMETOLOGIST
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Telephone | 678-656-7469
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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 |
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