Provider Demographics
NPI:1457628190
Name:C & W DURABLE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:C & W DURABLE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CRISP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-362-2990
Mailing Address - Street 1:1057 MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1482
Mailing Address - Country:US
Mailing Address - Phone:404-362-6901
Mailing Address - Fax:404-362-6904
Practice Address - Street 1:1057 MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1482
Practice Address - Country:US
Practice Address - Phone:404-362-6901
Practice Address - Fax:404-362-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies