Provider Demographics
NPI:1255343224
Name:CAROL MUELLE INC
Entity type:Organization
Organization Name:CAROL MUELLE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-815-0022
Mailing Address - Street 1:764 SAN ANTONIO DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3433
Mailing Address - Country:US
Mailing Address - Phone:404-815-0022
Mailing Address - Fax:404-748-1693
Practice Address - Street 1:764 SAN ANTONIO DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3433
Practice Address - Country:US
Practice Address - Phone:404-815-0022
Practice Address - Fax:404-748-1693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4553430001Medicare ID - Type Unspecified