Provider Demographics
NPI:1639369937
Name:ACME MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:ACME MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-320-1911
Mailing Address - Street 1:6298 VETERANS PKWY
Mailing Address - Street 2:2N
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-6258
Mailing Address - Country:US
Mailing Address - Phone:706-320-1911
Mailing Address - Fax:706-320-1922
Practice Address - Street 1:6298 VETERANS PKWY
Practice Address - Street 2:2N
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-6258
Practice Address - Country:US
Practice Address - Phone:706-320-1911
Practice Address - Fax:706-320-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5981830001Medicare NSC