Provider Demographics
NPI:1700236700
Name:SOFTTOUCH MEDICAL, LLC
Entity Type:Organization
Organization Name:SOFTTOUCH MEDICAL, LLC
Other - Org Name:AVEANNA HEALTHCARE MEDICAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-464-8000
Mailing Address - Street 1:400 INTERSTATE NORTH PKWY SE STE 1600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5047
Mailing Address - Country:US
Mailing Address - Phone:470-464-8000
Mailing Address - Fax:
Practice Address - Street 1:1018 US HIGHWAY 80 W
Practice Address - Street 2:UNIT 404
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-1600
Practice Address - Country:US
Practice Address - Phone:770-590-7383
Practice Address - Fax:770-499-0799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00764728AMedicaid
1164740001Medicare NSC