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General NPI Number Information
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NPI Number | 1982528790
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Entity Type | Organization
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Legal Business Name | CREATING IMAGES
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1540 HIGHWAY 138 SE
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City | CONYERS
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State | GA
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Zip | 30013-1297
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Country | US
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Telephone | 770-309-8446
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Fax |
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Provider Business Mailing Address
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Address Line | 30 HOMESTEAD WAY
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City | COVINGTON
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State | GA
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Zip | 30014-7608
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Country | US
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Telephone | 770-309-8446
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TREVAIL RINITE MATTOS
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Credential |
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Telephone | 770-309-8446
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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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