Provider Demographics
NPI:1659023679
Name:DME AND DIAGNOSTIC SERVICES
Entity Type:Organization
Organization Name:DME AND DIAGNOSTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAREL
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:404-578-1507
Mailing Address - Street 1:2045 MOUNT ZION RD # 351
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3313
Mailing Address - Country:US
Mailing Address - Phone:404-784-2906
Mailing Address - Fax:
Practice Address - Street 1:1261 PARKER RD SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5957
Practice Address - Country:US
Practice Address - Phone:404-784-2906
Practice Address - Fax:770-761-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies