Blue Wave Medical Supply, LLC

NPI #1659684959 in Hiram, Georgia

Provider Information

NPI Number
1659684959
Entity Type
Organization
Organization Name
Blue Wave Medical Supply, LLC
Primary Specialty
Durable Medical Equipment & Medical Supplies
Enumeration Date
Jul 15, 2010
Last Updated
Jul 15, 2010

Practice Location

Address
388 BAYWOOD WAY
City
Hiram
State
Georgia
ZIP Code
30141-4122
Phone
(404) 759-3594

Authorized Official

Name
MR. LAMARR DIXON
Title
OWNER
Phone
(404) 759-3594

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies

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