Provider Demographics
NPI:1639358062
Name:MEDICAL CARE CONSULTANTS
Entity Type:Organization
Organization Name:MEDICAL CARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-832-1227
Mailing Address - Street 1:PO BOX 1332
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30112-0025
Mailing Address - Country:US
Mailing Address - Phone:770-832-1227
Mailing Address - Fax:770-832-1213
Practice Address - Street 1:109 REJEN DR
Practice Address - Street 2:SUITE B
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4270
Practice Address - Country:US
Practice Address - Phone:770-832-1227
Practice Address - Fax:770-832-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2360630TF332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6054040001Medicare NSC