Healthcare Provider Details

I. General information

NPI: 1972188407
Provider Name (Legal Business Name): GFM MEDICAL SUPPLY AND EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 S CASHUA DR
FLORENCE SC
29501-6315
US

IV. Provider business mailing address

6139 GUILDFORD HILL LN
CHARLOTTE NC
28215-1888
US

V. Phone/Fax

Practice location:
  • Phone: 980-355-3104
  • Fax:
Mailing address:
  • Phone: 980-355-3104
  • 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: MS. DESTINEE MAYESE MONTELL FRAZIER
Title or Position: OWNER/ OPERATOR
Credential:
Phone: 980-355-3104