1144231622 NPI number — ABSOLUTE MEDICAL EQUIPMENT , INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144231622 NPI number — ABSOLUTE MEDICAL EQUIPMENT , INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABSOLUTE MEDICAL EQUIPMENT , INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144231622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 E GORDON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWNAN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30263-2214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-854-9234
Provider Business Mailing Address Fax Number:
678-854-9238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6014 MACON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31907-1934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-562-1600
Provider Business Practice Location Address Fax Number:
706-562-1929
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TEMPLES
Authorized Official First Name:
BRETT
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
678-854-9234

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00904736A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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