Provider Demographics
NPI:1134414691
Name:DME OF AMERICA
Entity type:Organization
Organization Name:DME OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-254-3135
Mailing Address - Street 1:4854 OLD NATIONAL HWY
Mailing Address - Street 2:SUITE 162
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-6221
Mailing Address - Country:US
Mailing Address - Phone:404-254-3135
Mailing Address - Fax:404-254-3137
Practice Address - Street 1:4854 OLD NATIONAL HWY
Practice Address - Street 2:SUITE 162
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-6221
Practice Address - Country:US
Practice Address - Phone:404-254-3135
Practice Address - Fax:404-254-3137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DME OF AMERICA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA249360129AMedicaid
GA249360129AMedicaid