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SHADAE RENEE MEDICAL WIGS NPI 1447860150


NPI Information

NPI: 1447860150
Provider Name: SHADAE RENEE MEDICAL WIGS
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
10719 ALPHARETTA HWY # 1792
ROSWELL, GA
ZIP 30076
Phone: (678) 362-6469
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SHADAE RENEE MEDICAL WIGS is a prosthetic orthotic supplier in Roswell, GA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. SHADAE RENEE MEDICAL WIGS NPI is 1447860150. The provider is registered as an organization entity type.

The provider's business location address is:

10719 ALPHARETTA HWY # 1792
ROSWELL, GA
ZIP 30076-432
Phone: (678) 362-6469
Fax: (678) 325-2731

The provider's authorized official is Shadae Green .
The authorized official title is Owner and has the following contact phone number (678) 362-6469.

The enumeration date for this NPI number is 8/6/2020 and was last updated on 8/6/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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