{"npi":"1801979596","type":"NPI-2","status":"active","name":{"display":"Southeastern Medical Brokers, Inc.","other":[],"organization_name":"SOUTHEASTERN MEDICAL BROKERS, INC.","authorised_official":"Brian Byler"},"specialty":{"primary_taxonomy":"332B00000X","primary_taxonomy_description":"Durable Medical Equipment & Medical Supplies","slug":"durable-medical-equipment-medical-supplies","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"4490 WASHINGTON RD STE 16","city":"EVANS","state":"GA","postal_code":"308095898","country_code":"US","phone":"7068558988","fax":"7068558902"},{"purpose":"MAILING","street_1":"4490 WASHINGTON RD STE 16","city":"EVANS","state":"GA","postal_code":"308095898","country_code":"US","phone":"7068558988","fax":"7068558902"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"703994050B","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"DE2463","state":"SC","issuer":null},{"type_code":"01","label":"Other","value":"52036372001","state":"GA","issuer":"BCBS"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100930035367","type_code":"30-54","type_desc":"DME SUPPLIER - MEDICAL SUPPLY COMPANY","state":"GA","pac_id":"2860606530"}]},"enumeration_date":"2006-10-24","last_updated":"2021-09-30","_meta":{"source":"NPPES","snapshot_date":"2021-09-30","doc_url":"https://findmynpi.com/api"}}