Provider Demographics
NPI:1487670410
Name:NOURISIAN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NOURISIAN MEDICAL CORPORATION
Other - Org Name:NOURISIAN INTERNATIONAL HEALTHCARE SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMADIS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1800-761-0809
Mailing Address - Street 1:PO BOX 921602
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30010-1602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1720 PEACHTREE ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2449
Practice Address - Country:US
Practice Address - Phone:800-761-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies