TANNER MEDICAL CENTER, INC.
NPI 1104850965
Durable Medical Equipment & Medical Supplies in Carrollton, GA
About Tanner Medical Center, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TANNER MEDICAL CENTER, INC. (NPI 1104850965), doing business as Tanner Boutique, is a healthcare organization registered as a durable medical equipment & medical supplies in Carrollton, Georgia and active in the NPI registry since July 2006. The organization lists Carol S. Crews, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tanner Medical Center, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tanner Medical Center, Inc.'s NPI number?
The NPI number for Tanner Medical Center, Inc. is 1104850965. It was assigned to this organization in the NPPES registry on July 10, 2006. The provider is doing business as Tanner Boutique.
Where is Tanner Medical Center, Inc. located?
Tanner Medical Center, Inc. is located at 706 Dixie St Ste 110, Carrollton, GA 30117. The listed phone number is (770) 812-8338.
What is Tanner Medical Center, Inc.'s specialty?
The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
Is Tanner Medical Center, Inc. enrolled in Medicare?
Yes. Tanner Medical Center, Inc. is registered in the Medicare PECOS enrollment system.
When is Tanner Medical Center, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Georgia, Medical Supply Company) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
When was this NPI record last updated?
The NPPES record for Tanner Medical Center, Inc. was last updated on June 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tanner Medical Center, Inc. · NPI 1104850965
Durable Medical Equipment & Medical Supplies organization in Carrollton, Georgia. Organization record, active in the CMS NPPES registry since July 10, 2006.
## Identity
- **NPI:** 1104850965 (Entity type: Organization)
- **Enumerated:** July 10, 2006
- **Primary specialty:** Durable Medical Equipment & Medical Supplies · taxonomy 332B00000X
- **Also known as:** Tanner Boutique (Doing Business As)
- **Organization subpart:** Yes (part of Tanner Medical Center, Inc.)
- **Authorized official:** Carol Crews, CFO
## Practice location
- **Address:** 706 DIXIE ST STE 110, Carrollton, GA 30117-3858
- **Phone:** (770) 812-8338
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (DME, Georgia, Medical Supply Company) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** June 26, 2025
- **Other identifiers:** Medicaid 000001867C (GA); Medicaid 000001867B (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1104850965) · Data from the CMS NPPES public registry.