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General NPI Number Information
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NPI Number | 1760939086
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Entity Type | Organization
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Legal Business Name | GU3 INDUSTRIES
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 38444 N JOANN WAY
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-4027
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Country | US
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Telephone | 480-290-8229
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Fax | 480-393-7353
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Provider Business Mailing Address
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Address Line | 38444 N JOANN WAY
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-4027
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Country | US
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Telephone | 480-290-8229
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Fax | 480-393-7353
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY J CAGLE-GUTHRIE
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Credential | CCSH, RPSGT, RST
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Telephone | 480-290-8229
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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 | 21113396
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License Number State | AZ
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