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General NPI Number Information
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NPI Number | 1619596624
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Entity Type | Organization
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Legal Business Name | GZ SERVICE INC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 576 JENNIFER CIR
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City | MUNDELEIN
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State | IL
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Zip | 60060-4110
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Country | US
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Telephone | 847-293-6903
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Fax |
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Provider Business Mailing Address
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Address Line | 576 JENNIFER CIR
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City | MUNDELEIN
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State | IL
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Zip | 60060-4110
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Country | US
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Telephone | 847-293-6903
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GRIGORIY ZELICHENKO
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Credential |
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Telephone | 847-749-5598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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