Provider Demographics
NPI:1386534337
Name:DONACO MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:DONACO MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-401-2628
Mailing Address - Street 1:2295 TOWNE LAKE PKWY STE 116
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5562
Mailing Address - Country:US
Mailing Address - Phone:877-424-2562
Mailing Address - Fax:877-832-9663
Practice Address - Street 1:227 W 4TH ST STE 318
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-1545
Practice Address - Country:US
Practice Address - Phone:877-832-9663
Practice Address - Fax:877-424-2562
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DONACO MEDICAL SUPPLY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies