Provider Demographics
NPI:1598044208
Name:SCOOTER CHAIR REPAIR GEORGIA, LLC
Entity Type:Organization
Organization Name:SCOOTER CHAIR REPAIR GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DELBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RINQUEST
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:847-380-5635
Mailing Address - Street 1:3519 CHURCH ST
Mailing Address - Street 2:UNIT D
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-1723
Mailing Address - Country:US
Mailing Address - Phone:888-311-0202
Mailing Address - Fax:866-804-4850
Practice Address - Street 1:3519 CHURCH ST
Practice Address - Street 2:UNIT D
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-1723
Practice Address - Country:US
Practice Address - Phone:404-271-7426
Practice Address - Fax:866-804-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00227297332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies