Basic Information
Provider Information
NPI: 1023339280
EntityType: 2
ReplacementNPI:  
OrganizationName: ACCUCARE MEDICAL EQUIPMENT, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: SOUTHEAST HOMECARE & RESPIRATORY SERVICES LLC
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 220 W GERMANTOWN PIKE STE 250
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621437
CountryCode: US
TelephoneNumber: 6106306357
FaxNumber:  
Practice Location
Address1: 277 HIGHWAY 74 N STE 105&106
Address2:  
City: PEACHTREE CITY
State: GA
PostalCode: 302691569
CountryCode: US
TelephoneNumber: 4705931100
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/22/2010
LastUpdateDate: 09/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS LLC
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BC3200X  N SuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
332BP3500X  N SuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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