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General NPI Number Information
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NPI Number | 1841246303
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Entity Type | Organization
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Legal Business Name | T.M. NICHOLS LLC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5825 GLENRIDGE DR NE SUITE 1-112
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City | ATLANTA
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State | GA
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Zip | 30328-5387
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Country | US
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Telephone | 404-847-9670
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Fax | 404-847-9669
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Provider Business Mailing Address
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Address Line | 5825 GLENRIDGE DR NE SUITE 1-112
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City | ATLANTA
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State | GA
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Zip | 30328-5387
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Country | US
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Telephone | 404-847-9670
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Fax | 404-847-9669
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MS. BERYL MARSH
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Credential |
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Telephone | 404-847-9670
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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 | BL05-02072
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License Number State | GA
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