Provider Demographics
NPI:1053626416
Name:S2 MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:S2 MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-824-6290
Mailing Address - Street 1:2780 PEACHTREE INDUSTRIAL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7910
Mailing Address - Country:US
Mailing Address - Phone:678-824-6290
Mailing Address - Fax:678-824-6296
Practice Address - Street 1:6650 SUGARLOAF PKWY STE 300
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4359
Practice Address - Country:US
Practice Address - Phone:678-824-6290
Practice Address - Fax:678-824-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003106260AMedicaid
TX1053626416Medicaid
MD0435660 00Medicaid
SCDM1434Medicaid
SCDM1434Medicaid
OH3135146Medicaid
TN1524343Medicaid
IL=========001Medicaid