MEDICARE: GENETICME 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	:	1851701122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENETICME INC

Provider Business Mailing Address
First Line	:	2575 PEACHTREE RD NE
Second Line	:	SUITE 304
City	:	ATLANTA
State	:	GA
Zip	:	30305-3694
Country	:	US
Telephone Number	:	888-365-9327
Fax Number	:	888-365-9327

Provider Business Practice Location Address
First Line	:	2575 PEACHTREE RD NE
Second Line	:	SUITE 304
City	:	ATLANTA
State	:	GA
Zip	:	30305-3694
Country	:	US
Telephone Number	:	888-365-9327
Fax Number	:	888-365-9327

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	MATTHEW C JAMES
Credential	:
Telephone Number	:	888-365-9327

Provider Enumeration Date	:	05/07/2014
Last Update Date	:	05/07/2014

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