Healthcare Provider Details

I. General information

NPI: 1487664793
Provider Name (Legal Business Name): GARYFS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1347 ENCINITAS BLVD
ENCINITAS CA
92024-2845
US

IV. Provider business mailing address

1347 ENCINITAS BLVD
ENCINITAS CA
92024-2845
US

V. Phone/Fax

Practice location:
  • Phone: 760-634-1600
  • Fax: 760-634-1616
Mailing address:
  • Phone: 760-634-1600
  • Fax: 760-634-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GARY GRAMKOW
Title or Position: OWNER
Credential:
Phone: 760-634-1600