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PREMIUM MEDICAL SUPPLY LLC
NPI 1164915427
Durable Medical Equipment & Medical Supplies in Decatur, GA

Active since June 12, 2018
3011 RAINBOW DR STE 303, DECATUR, GA 30034(404) 448-4577 Get Directions Write a Review

NPPES record last updated: December 5, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 5, 2018, Jun 12, 2018 (2 updates tracked since 2018).

About Premium Medical Supply Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIUM MEDICAL SUPPLY LLC (NPI 1164915427) is a healthcare organization registered as a durable medical equipment & medical supplies in Decatur, Georgia and active in the NPI registry since June 2018. The organization lists Keyanna Willis, President, as its authorized official.

NPPES Registry Identity

NPI1164915427
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NamePREMIUM MEDICAL SUPPLY LLC
Location Address3011 RAINBOW DR STE 303Decatur, GA 30034-1681
Mailing Address3011 Rainbow Dr Ste 303Decatur, GA 30034-1681
Phone(404) 448-4577
Organization SubpartNo
Authorized OfficialKeyanna WillisPresident · (404) 448-4577
Enumeration DateJune 12, 2018
Last NPPES UpdateDecember 5, 20182 updates tracked since enumeration
✔ NPI 1164915427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
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's use in the home and that are usable for an extended period of time.
3011 RAINBOW DR STE 303, Decatur, GA 30034
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLISTIC ANGELS PROVIDER SERVICES COMPANY
Home Health
3011 RAINBOW DR STE 303
DECATUR, GA 30034
Dekalb County (678) 773-0291

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 Premium Medical Supply LLC's NPI number?

The NPI number for Premium Medical Supply LLC is 1164915427. It was assigned to this organization in the NPPES registry on June 12, 2018.

Where is Premium Medical Supply LLC located?

Premium Medical Supply LLC is located at 3011 Rainbow Dr Ste 303, Decatur, GA 30034. The listed phone number is (404) 448-4577.

What is Premium Medical Supply LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Premium Medical Supply LLC was last updated on December 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.