Healthcare Provider Details

I. General information

NPI: 1174771315
Provider Name (Legal Business Name): CGL SOLUTIONS - MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6312 SNOW RIDGE CT
ARLINGTON TX
76018-3160
US

IV. Provider business mailing address

PO BOX 180441
ARLINGTON TX
76096-0441
US

V. Phone/Fax

Practice location:
  • Phone: 214-918-0594
  • Fax: 972-803-3538
Mailing address:
  • Phone: 214-918-0594
  • Fax: 972-803-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MISS COQUICE LOGAN
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 214-918-0594