MEDICARE: GEORGIA MEDICAL EQUIPMENT AND RESPIRATORY 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	332B00000X	GA

General Provider Information

NPI Number	:	1205831765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGIA MEDICAL EQUIPMENT AND RESPIRATORY SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 670
Second Line	:
City	:	MILLEDGEVILLE
State	:	GA
Zip	:	31059-0670
Country	:	US
Telephone Number	:	478-451-5185
Fax Number	:	478-451-5187

Provider Business Practice Location Address
First Line	:	1891 N COLUMBIA ST
Second Line	:	STE 109
City	:	MILLEDGEVILLE
State	:	GA
Zip	:	31061-2368
Country	:	US
Telephone Number	:	478-451-5185
Fax Number	:	478-451-5187

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEROME H HUELLEMEIER
Credential	:
Telephone Number	:	478-451-5185

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/10/2007

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