Healthcare Provider Details

I. General information

NPI: 1679578678
Provider Name (Legal Business Name): GAYCO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 INDUSTRIAL BLVD
DUBLIN GA
31021-1714
US

IV. Provider business mailing address

1101 HILLCREST PKWY STE C
DUBLIN GA
31021-3578
US

V. Phone/Fax

Practice location:
  • Phone: 478-353-1579
  • Fax: 877-477-2499
Mailing address:
  • Phone: 478-272-8093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number006970
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BENT GAY
Title or Position: CEO
Credential:
Phone: 478-353-1579