Provider Demographics
NPI:1508398298
Name:PYRUS SUPPLY LLC
Entity Type:Organization
Organization Name:PYRUS SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OSMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIFU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-785-7810
Mailing Address - Street 1:1585 STEPHENS POND VW
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-8756
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1585 STEPHENS POND VW
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-8756
Practice Address - Country:US
Practice Address - Phone:678-785-7810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies