Provider Demographics
NPI:1316970684
Name:ATLANTA MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:ATLANTA MEDICAL EQUIPMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAJJ
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEMIENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-323-2990
Mailing Address - Street 1:PO BOX 170188
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-0188
Mailing Address - Country:US
Mailing Address - Phone:770-323-2990
Mailing Address - Fax:770-323-2729
Practice Address - Street 1:2550 E WESLEY CHAPEL WAY
Practice Address - Street 2:SUITE 4
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3430
Practice Address - Country:US
Practice Address - Phone:770-323-2990
Practice Address - Fax:770-323-2729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5848520001Medicare NSC