Provider Demographics
NPI:1235365396
Name:AGELESS DESIGN INC.
Entity Type:Organization
Organization Name:AGELESS DESIGN INC.
Other - Org Name:THE ALZHEIMER'S STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-947-4001
Mailing Address - Street 1:3197 TROUT PLACE RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8260
Mailing Address - Country:US
Mailing Address - Phone:678-947-4001
Mailing Address - Fax:678-947-8411
Practice Address - Street 1:3197 TROUT PLACE RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8260
Practice Address - Country:US
Practice Address - Phone:678-947-4001
Practice Address - Fax:678-947-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies