Basic Information
| Provider Information | |||||||||
| NPI: | 1639358062 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL CARE CONSULTANTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1332 | ||||||||
| Address2: | |||||||||
| City: | CARROLLTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301120025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708321227 | ||||||||
| FaxNumber: | 7708321213 | ||||||||
| Practice Location | |||||||||
| Address1: | 109 REJEN DR | ||||||||
| Address2: | SUITE B | ||||||||
| City: | CARROLLTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301174270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708321227 | ||||||||
| FaxNumber: | 7708321213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2007 | ||||||||
| LastUpdateDate: | 05/04/2011 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | TONY | ||||||||
| AuthorizedOfficialMiddleName: | DALE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CLINICAL CONSULTANT | ||||||||
| AuthorizedOfficialTelephone: | 7708321227 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 2360630TF | GA | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.