Provider Demographics
NPI:1497800551
Name:ON THE GO MEDICAL, LLC
Entity Type:Organization
Organization Name:ON THE GO MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MOORE
Authorized Official - Last Name:SCHRATWIESER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:678-738-0047
Mailing Address - Street 1:PO BOX 440127
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30160-9503
Mailing Address - Country:US
Mailing Address - Phone:678-738-0047
Mailing Address - Fax:678-738-0051
Practice Address - Street 1:1310 KENNESTONE CIR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6092
Practice Address - Country:US
Practice Address - Phone:678-738-0047
Practice Address - Fax:678-738-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA3868930001Medicare ID - Type Unspecified