Provider Demographics
NPI:1346724325
Name:GANM, LLC
Entity type:Organization
Organization Name:GANM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/AGENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOORE-MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-363-2200
Mailing Address - Street 1:415 WHITLOCK PARIS RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-8865
Mailing Address - Country:US
Mailing Address - Phone:731-363-2200
Mailing Address - Fax:
Practice Address - Street 1:130 HIGHWAY 69 N
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-7590
Practice Address - Country:US
Practice Address - Phone:731-924-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies