Provider Demographics
NPI:1467218446
Name:SAFECARE MEDICAL SUPPLY AND SERVICES LLC
Entity Type:Organization
Organization Name:SAFECARE MEDICAL SUPPLY AND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MGBEMENA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:404-277-9890
Mailing Address - Street 1:115 COMMERCE DR STE J
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7335
Mailing Address - Country:US
Mailing Address - Phone:404-277-9890
Mailing Address - Fax:
Practice Address - Street 1:115 COMMERCE DR STE J
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7335
Practice Address - Country:US
Practice Address - Phone:770-703-8055
Practice Address - Fax:770-703-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies