Provider Demographics
NPI:1750645818
Name:SOUTHWIND AGENCY, INC.
Entity type:Organization
Organization Name:SOUTHWIND AGENCY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES & CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:CFTS
Authorized Official - Phone:706-867-0009
Mailing Address - Street 1:406 E MAIN ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0529
Mailing Address - Country:US
Mailing Address - Phone:706-867-0009
Mailing Address - Fax:866-276-9548
Practice Address - Street 1:406 E MAIN ST
Practice Address - Street 2:SUITE F
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0529
Practice Address - Country:US
Practice Address - Phone:706-867-0009
Practice Address - Fax:866-276-9548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies