Provider Demographics
NPI:1902287816
Name:AMERIMED PHARMACY & EQUIPMENT, LLC.
Entity Type:Organization
Organization Name:AMERIMED PHARMACY & EQUIPMENT, LLC.
Other - Org Name:AMERIMED EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-253-0067
Mailing Address - Street 1:202 4TH ST W
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-4356
Mailing Address - Country:US
Mailing Address - Phone:229-472-1067
Mailing Address - Fax:229-472-1069
Practice Address - Street 1:202 4TH ST W
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-4356
Practice Address - Country:US
Practice Address - Phone:229-472-1067
Practice Address - Fax:229-472-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5846580002Medicare NSC