Provider Demographics
NPI:1851661797
Name:SOUTHEASTERN MEDICAL BROKERS, INC.
Entity Type:Organization
Organization Name:SOUTHEASTERN MEDICAL BROKERS, INC.
Other - Org Name:INTEGRITY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-855-8988
Mailing Address - Street 1:1739 TULLIE CIR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2305
Mailing Address - Country:US
Mailing Address - Phone:404-355-7333
Mailing Address - Fax:404-355-7300
Practice Address - Street 1:1739 TULLIE CIR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2305
Practice Address - Country:US
Practice Address - Phone:404-355-7333
Practice Address - Fax:404-355-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies