Provider Demographics
NPI:1730125444
Name:S & S MEDICAL MANAGEMENT, SERVICES, INC.
Entity Type:Organization
Organization Name:S & S MEDICAL MANAGEMENT, SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-717-9200
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:PINE LAKE
Mailing Address - State:GA
Mailing Address - Zip Code:30072-0430
Mailing Address - Country:US
Mailing Address - Phone:770-717-9200
Mailing Address - Fax:770-717-9242
Practice Address - Street 1:5385 FIVE FORKS TRICKUM RD
Practice Address - Street 2:SUITE H
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087
Practice Address - Country:US
Practice Address - Phone:770-717-9200
Practice Address - Fax:770-717-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2006019013332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000937956AMedicaid
GA=========Medicare UPIN
GA3935380001Medicare NSC