Organization · Type 2 NPI

Mercy Medical Supply LLC

Customized Equipment (DME) · Stockbridge, GA

NPI number 1477702801 Active

Practice location

3584 Highway 138 SE
Stockbridge, GA 30281

Fax (770) 506-9921

Specialties and licenses

Taxonomy	Code	License
Customized Equipment (DME) Primary	332BC3200X	None listed

Customized Equipment (DME): Definition to come...

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NPI record

NPI: 1477702801
Entity type: Organization (Type 2)
Issued: Sep 10, 2008
Last updated: Aug 31, 2018
Status: Active
Subpart: Yes of Mercy Medical Supply, LLC

Other names

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Mercy Medical Supply, LLC · doing business as
Mercy Medical Supply, LLC · doing business as

Authorized official

Ms. Jacqueline Kay Johnson
President/owner
(770) 506-9944

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1477702801

Mercy Medical Supply LLC's National Provider Identifier is 1477702801, issued on Sep 10, 2008. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Stockbridge, GA. The record was last updated on Aug 31, 2018.