MEDICARE: PROGRESSIVE CARE SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1144226929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	4051 GOLFVIEW COURT
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180
Country	:	US
Telephone Number	:	770-214-9890
Fax Number	:

Provider Business Practice Location Address
First Line	:	4051 GOLFVIEW CT
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-8510
Country	:	US
Telephone Number	:	770-214-9890
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. RICHARD E FLEEHARTY
Credential	:
Telephone Number	:	770-214-9890

Provider Enumeration Date	:	06/25/2005
Last Update Date	:	05/05/2010

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