Healthcare Provider Details

I. General information

NPI: 1144499567
Provider Name (Legal Business Name): GINGER-K CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16360 MONTEREY ROAD SUITE 270
MORGAN HILL CA
95037-5406
US

IV. Provider business mailing address

16360 MONTEREY ROAD SUITE 270
MORGAN HILL CA
95037-5406
US

V. Phone/Fax

Practice location:
  • Phone: 408-782-1028
  • Fax: 408-782-1061
Mailing address:
  • Phone: 408-782-1028
  • Fax: 408-782-1061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number44990
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number44990
License Number StateCA

VIII. Authorized Official

Name: MS. PHYLLIS MARIE TUBBS-GINGERICH
Title or Position: OWNER/DIRECTOR
Credential: RN, BSN, LE, CLT
Phone: 408-782-1028