Pruitthealth Nutritional Supply

LBN: Pruitthealth Nutritional Supply, Inc.
Pruitthealth Nutritional Supply is an health care organization with primary practice located at 1626 Jeurgens Court , Norcross GA 30093-2219. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Pruitthealth Nutritional Supply, Inc. can be contacted via phone (866) 520-1214, or through Pruitt, Neil L via phone (770) 279-6200.

Contact Information

Primary practice address
1626 Jeurgens Court Norcross GA 30093-2219
Phone: (866) 520-1214
Fax: (770) 931-5262
Website:
Map and Directions
Authorized official contact:
Name: Pruitt, Neil L
Phone: (770) 279-6200

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1235186495
LBN Legal business name Pruitthealth Nutritional Supply, Inc.
DBA Doing business as Pruitthealth Nutritional Supply
Authorized official Pruitt, Neil L
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2006
Last updated Apr 9th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235186495 NPPES
Georgia MEDICAID 00419031A

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