MEDICARE: DOMINION DME 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	:	1689482739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOMINION DME INC

Provider Business Mailing Address
First Line	:	1290 KENNESTONE CIR STE A112
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-6010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1290 KENNESTONE CIR STE A112
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-6010
Country	:	US
Telephone Number	:	678-904-6475
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	QADEER MOHAMMED
Credential	:
Telephone Number	:	678-904-6475

Provider Enumeration Date	:	12/20/2024
Last Update Date	:	03/26/2025

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Directions to “DOMINION DME INC ” Practice Location

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