Provider Demographics
NPI:1013457423
Name:CENTURY GROUP SUPPLY INC
Entity Type:Organization
Organization Name:CENTURY GROUP SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-332-4731
Mailing Address - Street 1:55 IVAN ALLEN JR BLVD NW STE 530
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-3054
Mailing Address - Country:US
Mailing Address - Phone:470-332-4731
Mailing Address - Fax:
Practice Address - Street 1:55 IVAN ALLEN JR BLVD NW STE 530
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-3054
Practice Address - Country:US
Practice Address - Phone:470-332-4731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies