Provider Demographics
NPI:1952899056
Name:RAYNEB MEDICAL
Entity Type:Organization
Organization Name:RAYNEB MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-646-0048
Mailing Address - Street 1:105 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-4160
Mailing Address - Country:US
Mailing Address - Phone:706-646-0048
Mailing Address - Fax:706-646-0049
Practice Address - Street 1:105 N CENTER ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-4160
Practice Address - Country:US
Practice Address - Phone:706-646-0048
Practice Address - Fax:706-646-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies