Provider Demographics
NPI:1679850598
Name:ARRENEL MEDICAL SUPPLIERS, LLC.
Entity Type:Organization
Organization Name:ARRENEL MEDICAL SUPPLIERS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:N
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-735-0028
Mailing Address - Street 1:333 SWANSON DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8536
Mailing Address - Country:US
Mailing Address - Phone:678-735-0028
Mailing Address - Fax:678-735-0097
Practice Address - Street 1:333 SWANSON DR
Practice Address - Street 2:SUITE 130
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-8536
Practice Address - Country:US
Practice Address - Phone:678-735-0028
Practice Address - Fax:678-735-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-06
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA19124998332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6695310001Medicare NSC