MEDICARE: VIABLE MEDICAL EQUIPMENT 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	:	1922626605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIABLE MEDICAL EQUIPMENT INC

Provider Business Mailing Address
First Line	:	2310 PARKLAKE DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2310 PARKLAKE DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2913
Country	:	US
Telephone Number	:	470-550-1503
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	XEANLAND CHENNELLS
Credential	:
Telephone Number	:	470-685-8265

Provider Enumeration Date	:	07/09/2020
Last Update Date	:	07/09/2020

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