Provider Demographics
NPI:1902787229
Name:DEANNA GROSS MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:DEANNA GROSS MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-917-3721
Mailing Address - Street 1:746 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-7451
Mailing Address - Country:US
Mailing Address - Phone:404-917-3721
Mailing Address - Fax:
Practice Address - Street 1:746 16TH AVE S
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-7451
Practice Address - Country:US
Practice Address - Phone:404-917-3721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies