Provider Demographics
NPI:1720452980
Name:COLLY MED EQUIPMENT LLC
Entity Type:Organization
Organization Name:COLLY MED EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-676-3346
Mailing Address - Street 1:40 BURTON HILLS BLVD
Mailing Address - Street 2:200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6199
Mailing Address - Country:US
Mailing Address - Phone:281-676-3346
Mailing Address - Fax:
Practice Address - Street 1:40 BURTON HILLS BLVD
Practice Address - Street 2:200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6199
Practice Address - Country:US
Practice Address - Phone:281-676-3346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies