Provider Demographics
NPI:1770796021
Name:FAMILY CARE MEDICAL PRODUCTS INC
Entity type:Organization
Organization Name:FAMILY CARE MEDICAL PRODUCTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMOS
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:STONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:770-487-1484
Mailing Address - Street 1:PO BOX 3569
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:770-487-1484
Mailing Address - Fax:770-487-1575
Practice Address - Street 1:375 HIGHWAY 74 S
Practice Address - Street 2:STE A
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-2059
Practice Address - Country:US
Practice Address - Phone:770-487-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1252140001Medicare ID - Type Unspecified