Healthcare Provider Details

I. General information

NPI: 1730798109
Provider Name (Legal Business Name): G & S DURABLE MEDICAL EQUIPMENT AND SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MASON ST
HAMMOND IN
46320-2324
US

IV. Provider business mailing address

48 MASON ST
HAMMOND IN
46320-2324
US

V. Phone/Fax

Practice location:
  • Phone: 773-875-5027
  • Fax:
Mailing address:
  • Phone: 773-875-5027
  • Fax:

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 Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. LEODIS F SCOTT
Title or Position: CONTROLLER
Credential:
Phone: 773-875-5027