Provider Demographics
NPI:1982641643
Name:MEDIPOD, LLC
Entity Type:Organization
Organization Name:MEDIPOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PENDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-263-8839
Mailing Address - Street 1:6961 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3647
Mailing Address - Country:US
Mailing Address - Phone:770-263-8839
Mailing Address - Fax:
Practice Address - Street 1:6961 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:#220
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-3647
Practice Address - Country:US
Practice Address - Phone:770-263-8839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
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
GA5653160001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT