Provider Demographics
NPI:1568045334
Name:SHAYWAY'S VALUE SHOPPE
Entity Type:Organization
Organization Name:SHAYWAY'S VALUE SHOPPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SHAY
Authorized Official - Last Name:PRESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-664-6475
Mailing Address - Street 1:730 PEACHTREE ST NE STE 570
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1244
Mailing Address - Country:US
Mailing Address - Phone:404-664-6475
Mailing Address - Fax:
Practice Address - Street 1:2570 BEDFORD PLACE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-3121
Practice Address - Country:US
Practice Address - Phone:404-664-6475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies