Provider Demographics
NPI:1609001783
Name:POWERCONNECTS
Entity Type:Organization
Organization Name:POWERCONNECTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:LAMONTE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:678-247-3616
Mailing Address - Street 1:1950 ENCHANTED WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-1979
Mailing Address - Country:US
Mailing Address - Phone:678-247-3616
Mailing Address - Fax:678-401-2654
Practice Address - Street 1:530 COMMERCE PARK DR SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2782
Practice Address - Country:US
Practice Address - Phone:678-247-3616
Practice Address - Fax:678-401-2654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies