| Organization Name: | ALTAMAHA DME, INC |
| NPI Number: | 1013990134 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRI L BRAKE (PRESIDENT) |
| Mailing Address: | 477 South First Street Jesup |
| State: | GA US |
| Postal Code: | 31545 |
| Phone Number: | 9124276600 |
| Fax Number: | 9124278003 |
| NPI Enumeration Date: | 11/22/2005 |
| NPI Last Update Date: | 04/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | 000001538 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |