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General NPI Number Information
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NPI Number | 1174186993
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Entity Type | Organization
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Legal Business Name | G5 MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 77 NE 3RD AVE
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-3526
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Country | US
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Telephone | 954-906-5223
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Fax |
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Provider Business Mailing Address
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Address Line | 77 NE 3RD AVE
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-3526
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Country | US
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Telephone | 954-906-5223
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | CHRISTIAN GARGUILO
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Credential |
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Telephone | 954-906-5223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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