Provider Demographics
NPI:1780057737
Name:TW MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:TW MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:678-580-5977
Mailing Address - Street 1:5040 SNAPFINGER WOODS DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035
Mailing Address - Country:US
Mailing Address - Phone:678-580-5977
Mailing Address - Fax:770-558-4756
Practice Address - Street 1:5040 SNAPFINGER WOODS DR
Practice Address - Street 2:SUITE 105
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035
Practice Address - Country:US
Practice Address - Phone:678-580-5977
Practice Address - Fax:770-558-4756
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TW MEDICAL SUPPLIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-12
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies