Provider Demographics
NPI:1770806648
Name:ARE MEDICAL, INC
Entity type:Organization
Organization Name:ARE MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-242-2114
Mailing Address - Street 1:PO BOX 3266
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-3266
Mailing Address - Country:US
Mailing Address - Phone:229-242-2114
Mailing Address - Fax:
Practice Address - Street 1:5109 NORTHWIND BLVD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-7674
Practice Address - Country:US
Practice Address - Phone:229-242-2114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies