Provider Demographics
NPI:1588816177
Name:DMDPRNT LLC
Entity Type:Organization
Organization Name:DMDPRNT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAUVERN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLINGSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED INSURANCE
Authorized Official - Phone:770-505-5730
Mailing Address - Street 1:300 W I PARKWAY
Mailing Address - Street 2:SUITE 311
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132
Mailing Address - Country:US
Mailing Address - Phone:770-505-5730
Mailing Address - Fax:678-388-9117
Practice Address - Street 1:300 W I PKWY
Practice Address - Street 2:SUITE 311
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-5079
Practice Address - Country:US
Practice Address - Phone:770-505-5730
Practice Address - Fax:678-388-9117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies