Provider Demographics
NPI:1376775759
Name:DURABLE MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:DURABLE MEDICAL EQUIPMENT, INC
Other - Org Name:CARROLLTON HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BECKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:678-796-1800
Mailing Address - Street 1:107 CLINIC AVE
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4413
Mailing Address - Country:US
Mailing Address - Phone:678-796-1800
Mailing Address - Fax:678-796-1895
Practice Address - Street 1:107 CLINIC AVE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4413
Practice Address - Country:US
Practice Address - Phone:678-796-1800
Practice Address - Fax:678-796-1895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004269332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4264210006Medicare NSC