Provider Demographics
NPI:1992055123
Name:PUBLIC MEDICAL EQUIPMENT COMPANY
Entity type:Organization
Organization Name:PUBLIC MEDICAL EQUIPMENT COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAIAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-207-8421
Mailing Address - Street 1:585 VINE ST
Mailing Address - Street 2:STE 4
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-6401
Mailing Address - Country:US
Mailing Address - Phone:706-207-8421
Mailing Address - Fax:
Practice Address - Street 1:585 VINE ST
Practice Address - Street 2:STE 4
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-6401
Practice Address - Country:US
Practice Address - Phone:706-207-8421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies