Provider Demographics
NPI:1518284231
Name:MILES MANAGEMENT GROUP, INC
Entity Type:Organization
Organization Name:MILES MANAGEMENT GROUP, INC
Other - Org Name:HOMETOWN MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:706-507-2222
Mailing Address - Street 1:506 MANCHESTER EXPY
Mailing Address - Street 2:SUITE B-13
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6444
Mailing Address - Country:US
Mailing Address - Phone:706-507-2222
Mailing Address - Fax:706-507-2233
Practice Address - Street 1:506 MANCHESTER EXPY
Practice Address - Street 2:SUITE B-13
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6444
Practice Address - Country:US
Practice Address - Phone:706-507-2222
Practice Address - Fax:706-507-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6540680001Medicare NSC