Healthcare Provider Details

I. General information

NPI: 1255606729
Provider Name (Legal Business Name): GURLEY'S MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2012
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 GUESS RD STE 80
DURHAM NC
27701-1165
US

IV. Provider business mailing address

1720 GUESS RD STE 80
DURHAM NC
27701-1165
US

V. Phone/Fax

Practice location:
  • Phone: 919-237-3608
  • Fax: 919-237-3683
Mailing address:
  • Phone: 919-237-3608
  • Fax: 919-237-3683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JACK Y GURLEY
Title or Position: MANAGING OWNER
Credential:
Phone: 919-237-3608