Provider Demographics
NPI:1821600370
Name:PEACHTREE MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:PEACHTREE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CEDRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-920-9267
Mailing Address - Street 1:1230 PEACHTREE ST NE FL 19
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3574
Mailing Address - Country:US
Mailing Address - Phone:212-920-9267
Mailing Address - Fax:
Practice Address - Street 1:1230 PEACHTREE ST NE FL 19
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3574
Practice Address - Country:US
Practice Address - Phone:212-920-9267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies