Provider Demographics
NPI:1942348073
Name:AMERICARE MEDICAL AND SURGICAL SUPPLY CO
Entity Type:Organization
Organization Name:AMERICARE MEDICAL AND SURGICAL SUPPLY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ILUNOAMIE
Authorized Official - Last Name:OSHIOKPEKHAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-270-5350
Mailing Address - Street 1:2191 NORTHLAKE PKWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4166
Mailing Address - Country:US
Mailing Address - Phone:770-270-5350
Mailing Address - Fax:770-270-5349
Practice Address - Street 1:2191 NORTHLAKE PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4166
Practice Address - Country:US
Practice Address - Phone:770-270-5350
Practice Address - Fax:770-270-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5019260001Medicare ID - Type UnspecifiedPROVIDER #