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General NPI Number Information
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NPI Number | 1811204167
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Entity Type | Organization
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Legal Business Name | ALLCARE MEDICAL OF GEORGIA
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 220C BEN BURTON CIR
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City | BOGART
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State | GA
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Zip | 30622-6813
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Country | US
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Telephone | 706-549-2088
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Fax | 877-393-3347
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Provider Business Mailing Address
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Address Line | 164 MILESTONE WAY SUITE 210
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City | GREENVILLE
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State | SC
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Zip | 29615-5093
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Country | US
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Telephone | 864-263-4300
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Fax | 877-393-3347
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ONDREJ SLIVA
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Credential |
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Telephone | 864-263-4300
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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 | 308330212
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 308330212
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License Number State | GA
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