Provider Demographics
NPI:1699502286
Name:M MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:M MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:INSHIRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JIHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-845-6854
Mailing Address - Street 1:132 STANLEY CT STE E
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-9061
Mailing Address - Country:US
Mailing Address - Phone:678-845-6854
Mailing Address - Fax:470-276-6976
Practice Address - Street 1:132 STANLEY CT STE E
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-9061
Practice Address - Country:US
Practice Address - Phone:678-845-6854
Practice Address - Fax:470-276-6976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies