Provider Demographics
NPI:1427077627
Name:A D MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:A D MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:KING
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:229-639-0021
Mailing Address - Street 1:202 N WESTOVER BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-2900
Mailing Address - Country:US
Mailing Address - Phone:229-420-8890
Mailing Address - Fax:229-639-0081
Practice Address - Street 1:202 N WESTOVER BLVD
Practice Address - Street 2:STE B
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2900
Practice Address - Country:US
Practice Address - Phone:229-420-8890
Practice Address - Fax:229-639-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332BN1400X
332BP3500X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1043840001Medicare NSC