Provider Demographics
NPI:1144389933
Name:DEDMAN AND ASSOCIATES, INC
Entity Type:Organization
Organization Name:DEDMAN AND ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:DEDMAN, JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-830-9338
Mailing Address - Street 1:816 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3626
Mailing Address - Country:US
Mailing Address - Phone:770-834-6435
Mailing Address - Fax:770-834-1177
Practice Address - Street 1:816 MAPLE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3626
Practice Address - Country:US
Practice Address - Phone:770-834-6435
Practice Address - Fax:770-834-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002023332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherDME PROVIDER