Provider Demographics
NPI:1144687377
Name:MEDRX BRACING LLC
Entity type:Organization
Organization Name:MEDRX BRACING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-757-0198
Mailing Address - Street 1:200 PROFESSIONAL CT SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-7020
Mailing Address - Country:US
Mailing Address - Phone:866-757-0198
Mailing Address - Fax:866-437-3705
Practice Address - Street 1:200 PROFESSIONAL CT SE
Practice Address - Street 2:SUITE C
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7020
Practice Address - Country:US
Practice Address - Phone:866-757-0198
Practice Address - Fax:866-437-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies