Provider Demographics
NPI:1366734519
Name:GARANTHE MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:GARANTHE MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMAKRASHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-256-0682
Mailing Address - Street 1:2400 WISTERIA DR STE F
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2689
Mailing Address - Country:US
Mailing Address - Phone:678-404-8558
Mailing Address - Fax:770-441-9947
Practice Address - Street 1:2400 WISTERIA DR STE F
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2689
Practice Address - Country:US
Practice Address - Phone:678-404-8558
Practice Address - Fax:770-441-9947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAH514507332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH514507OtherDMEHS