Provider Demographics
NPI:1083773873
Name:GEORGIA DISCOUNT MEDICAL EQUIPMENT SUPPLY, INC
Entity Type:Organization
Organization Name:GEORGIA DISCOUNT MEDICAL EQUIPMENT SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:ORDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-286-1770
Mailing Address - Street 1:4319 COVINGTON HWY
Mailing Address - Street 2:102A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-1210
Mailing Address - Country:US
Mailing Address - Phone:404-281-1770
Mailing Address - Fax:
Practice Address - Street 1:4319 COVINGTON HWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1210
Practice Address - Country:US
Practice Address - Phone:404-281-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20017737978332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5721670001Medicare NSC