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General NPI Number Information
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NPI Number | 1902803000
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Entity Type | Organization
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Legal Business Name | MEDICAL EQUIPMENT SPECIALISTS
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 380 DAHLONEGA ST STE 103
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City | CUMMING
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State | GA
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Zip | 30040-8212
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Country | US
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Telephone | 470-253-8067
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Fax | 678-807-2998
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Provider Business Mailing Address
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Address Line | 5920 BOULDER BLUFF DR
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City | CUMMING
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State | GA
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Zip | 30040-1144
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Country | US
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Telephone | 470-249-9869
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Fax | 678-807-2998
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Authorized Official
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Title or Position | CEO
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Name | MR. ERIK JON KOLACINSKI
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Credential |
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Telephone | 470-249-9869
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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 |
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License Number State |
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