Provider Demographics
NPI:1679804561
Name:CONCISE MEDICAL SERVICES, LLC.
Entity Type:Organization
Organization Name:CONCISE MEDICAL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CONCISE MEDICAL SERV
Authorized Official - Middle Name:SERVICES
Authorized Official - Last Name:LLC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-502-7460
Mailing Address - Street 1:3545 CRUSE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-3170
Mailing Address - Country:US
Mailing Address - Phone:678-502-7460
Mailing Address - Fax:866-645-5987
Practice Address - Street 1:3545 CRUSE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-3170
Practice Address - Country:US
Practice Address - Phone:678-502-7460
Practice Address - Fax:866-645-5987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-17
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20100117332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20100117OtherDMEHS
GA6486050001Medicare NSC