Provider Demographics
NPI:1043481260
Name:DME SUPPLY INC
Entity Type:Organization
Organization Name:DME SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MAYWEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-851-3257
Mailing Address - Street 1:6368 FOREST HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1902
Mailing Address - Country:US
Mailing Address - Phone:404-664-2459
Mailing Address - Fax:770-991-9931
Practice Address - Street 1:1347 HIGHWAY 138 SW # 2
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-1403
Practice Address - Country:US
Practice Address - Phone:770-991-9931
Practice Address - Fax:770-991-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies