Provider Demographics
NPI:1396790564
Name:GILMER SENIOR CARE L.P.
Entity type:Organization
Organization Name:GILMER SENIOR CARE L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-843-5529
Mailing Address - Street 1:703 N TITUS
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75644-1740
Mailing Address - Country:US
Mailing Address - Phone:903-843-5524
Mailing Address - Fax:903-843-2608
Practice Address - Street 1:703 N TITUS
Practice Address - Street 2:
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75644-1740
Practice Address - Country:US
Practice Address - Phone:903-843-5524
Practice Address - Fax:903-843-2608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BN1400X332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1313900001Medicare ID - Type Unspecified