Provider Demographics
NPI:1700018850
Name:FRONTIER MARKETING OF GEORGIA, INC
Entity Type:Organization
Organization Name:FRONTIER MARKETING OF GEORGIA, INC
Other - Org Name:NATIONAL MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-990-7560
Mailing Address - Street 1:4947 LAVISTA RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4437
Mailing Address - Country:US
Mailing Address - Phone:678-990-7560
Mailing Address - Fax:678-990-7566
Practice Address - Street 1:4947 LAVISTA RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4437
Practice Address - Country:US
Practice Address - Phone:678-990-7560
Practice Address - Fax:678-990-7566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies