Provider Demographics
NPI:1063128841
Name:GM MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:GM MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONDESIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-227-0426
Mailing Address - Street 1:150 E SAMPLE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 E SAMPLE RD STE 340
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3550
Practice Address - Country:US
Practice Address - Phone:888-227-0426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies