Provider Demographics
NPI:1336371772
Name:OPTIMAL MEDICAL EQIUPMENT AND SUPPLY, LLC
Entity Type:Organization
Organization Name:OPTIMAL MEDICAL EQIUPMENT AND SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKWUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-846-6364
Mailing Address - Street 1:1025 E WEST CONNECTOR
Mailing Address - Street 2:SUITE 360
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-8513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1025 E WEST CONNECTOR
Practice Address - Street 2:SUITE 360
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8513
Practice Address - Country:US
Practice Address - Phone:678-524-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies