MEDICARE: GILL-WEST COMPANIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	MG00584	AR

General Provider Information

NPI Number	:	1346241692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILL-WEST COMPANIES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1479
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-1479
Country	:	US
Telephone Number	:	479-705-9401
Fax Number	:	479-705-8801

Provider Business Practice Location Address
First Line	:	1112 S ROGERS ST
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-9157
Country	:	US
Telephone Number	:	479-705-9401
Fax Number	:	479-705-8801

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ROBERTA C GILL
Credential	:
Telephone Number	:	479-705-9401

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/22/2020

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