Provider Demographics
NPI:1104850189
Name:ACCUCARE, INC.
Entity Type:Organization
Organization Name:ACCUCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:THROCKMORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-512-0090
Mailing Address - Street 1:11 DUNWOODY PARK
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7408
Mailing Address - Country:US
Mailing Address - Phone:770-512-0090
Mailing Address - Fax:
Practice Address - Street 1:11 DUNWOODY PARK
Practice Address - Street 2:SUITE 130
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-7408
Practice Address - Country:US
Practice Address - Phone:770-512-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1105520001Medicare NSC