Provider Demographics
NPI:1487748414
Name:DURABLE MEDICAL AND DIABETIC SOLUTIONS INC.
Entity type:Organization
Organization Name:DURABLE MEDICAL AND DIABETIC SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:JR
Authorized Official - Credentials:ATS
Authorized Official - Phone:912-429-9292
Mailing Address - Street 1:1306 HEIDT AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:GARDEN CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31408-2668
Mailing Address - Country:US
Mailing Address - Phone:912-966-0807
Mailing Address - Fax:912-966-0097
Practice Address - Street 1:1306 HEIDT AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GARDEN CITY
Practice Address - State:GA
Practice Address - Zip Code:31408-2668
Practice Address - Country:US
Practice Address - Phone:912-966-0807
Practice Address - Fax:912-966-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20013670463332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE1987Medicaid
SCDE1987Medicaid