Provider Demographics
NPI:1578894143
Name:THE DEGRINE GROUP, LLC
Entity Type:Organization
Organization Name:THE DEGRINE GROUP, LLC
Other - Org Name:MEDIQUIP HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL/OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:II
Authorized Official - Credentials:MBA, MPHA, MPH
Authorized Official - Phone:865-406-5578
Mailing Address - Street 1:860 JOHNSON FERRY RD NE STE 140-153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1435
Mailing Address - Country:US
Mailing Address - Phone:865-406-5578
Mailing Address - Fax:
Practice Address - Street 1:250 AUBURN AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2612
Practice Address - Country:US
Practice Address - Phone:865-406-5578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA142533332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies