Healthcare Provider Details

I. General information

NPI: 1255380226
Provider Name (Legal Business Name): GERICARE MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 WHETSTONE ST
MONROEVILLE AL
36460-2615
US

IV. Provider business mailing address

521 WHETSTONE ST
MONROEVILLE AL
36460-2615
US

V. Phone/Fax

Practice location:
  • Phone: 251-743-3844
  • Fax: 251-743-2495
Mailing address:
  • Phone: 251-743-3844
  • Fax: 251-743-2495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH W JONES JR.
Title or Position: PRESIDENT & OWNER
Credential:
Phone: 251-743-3844