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General NPI Number Information
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NPI Number | 1962782524
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Entity Type | Organization
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Legal Business Name | DISCO MEDICAL EQUIPMENT, L.L.C.
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 5685 BROOKSTONE WALK NW
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City | ACWORTH
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State | GA
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Zip | 30101-4582
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Country | US
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Telephone | 770-722-1041
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Fax |
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Provider Business Mailing Address
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Address Line | 5685 BROOKSTONE WALK NW
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City | ACWORTH
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State | GA
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Zip | 30101-4582
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Country | US
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Telephone | 770-722-1041
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. THOMAS DISCO
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Credential |
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Telephone | 770-722-1041
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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 | 11064567
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License Number State | GA
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