| Organization Name: | DIVINE HEALTHCARE SUPPLIES, LLC |
| NPI Number: | 1487786307 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALUMA K ORUH (ADMINISTRATOR) |
| Mailing Address: | 7380 Spout Springs Rd Suite 190 Flowery Branch |
| State: | GA US |
| Postal Code: | 305427541 |
| Phone Number: | 7709672193 |
| Fax Number: | 7709672199 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 03/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | BL07086 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |