Provider Demographics
NPI:1427339886
Name:MYERS MEDICAL, LLC
Entity type:Organization
Organization Name:MYERS MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-224-8811
Mailing Address - Street 1:16 BRIARCLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-9635
Mailing Address - Country:US
Mailing Address - Phone:912-224-8811
Mailing Address - Fax:912-349-4872
Practice Address - Street 1:16 BRIARCLIFF WAY
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-9635
Practice Address - Country:US
Practice Address - Phone:912-224-8811
Practice Address - Fax:912-349-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies