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General NPI Number Information
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NPI Number | 1831488667
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Entity Type | Organization
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Legal Business Name | GENTLE MEDICAL SYSTEM, LLC.
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 134 HURRICANE SHOALS RD NE STE G
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4445
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Country | US
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Telephone | 770-963-0034
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Fax | 404-935-9394
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Provider Business Mailing Address
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Address Line | 134 HURRICANE SHOALS RD NE STE G
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4445
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Country | US
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Telephone | 770-963-0034
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Fax | 404-935-9394
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. JOHN OLAWOYIN
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Credential |
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Telephone | 770-963-0034
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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 | 19124728
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License Number State | GA
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