Provider Demographics
NPI:1487885216
Name:ARMOR MEDICAL SUPPLY LLC ATLANTA
Entity type:Organization
Organization Name:ARMOR MEDICAL SUPPLY LLC ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:404-592-5306
Mailing Address - Street 1:2970 ASK KAY DR SE
Mailing Address - Street 2:STE A
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-2318
Mailing Address - Country:US
Mailing Address - Phone:404-592-5306
Mailing Address - Fax:404-592-5307
Practice Address - Street 1:2970 ASK KAY DR SE
Practice Address - Street 2:STE A
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-2318
Practice Address - Country:US
Practice Address - Phone:404-592-5306
Practice Address - Fax:404-592-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2011261332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA849310023AMedicaid
GA6299340001Medicare NSC