Provider Demographics
NPI:1225883614
Name:MR. NEB, LLC
Entity type:Organization
Organization Name:MR. NEB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-316-3685
Mailing Address - Street 1:PO BOX 922576
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30010-2576
Mailing Address - Country:US
Mailing Address - Phone:866-449-4784
Mailing Address - Fax:888-835-3354
Practice Address - Street 1:2225 BEMISS RD STE E
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-4819
Practice Address - Country:US
Practice Address - Phone:866-449-4784
Practice Address - Fax:888-835-3354
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MR. NEB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-19
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies