Provider Demographics
NPI:1972545614
Name:GEORGIA MEDICAL EQUIPMENT & SUPPLIES OF MACON, INC
Entity type:Organization
Organization Name:GEORGIA MEDICAL EQUIPMENT & SUPPLIES OF MACON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:B
Authorized Official - Last Name:TOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-746-7364
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31202-0085
Mailing Address - Country:US
Mailing Address - Phone:478-746-7364
Mailing Address - Fax:478-746-7366
Practice Address - Street 1:792 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3270
Practice Address - Country:US
Practice Address - Phone:478-746-7364
Practice Address - Fax:478-746-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00649272AMedicaid
0127400001Medicare ID - Type Unspecified