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General NPI Number Information
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NPI Number | 1942592332
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Entity Type | Individual
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Provider Name | SHANNA D PYE
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Gender | Female
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 500 WILOAKS DR G
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City | SNELLVILLE
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State | GA
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Zip | 30039-3995
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Country | US
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Telephone | 678-774-9793
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 391302
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City | SNELLVILLE
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State | GA
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Zip | 30039-3995
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Country | US
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Telephone | 678-774-9793
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2011016351
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License Number State | GA
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