MEDICARE: GARLOCK ENTERPRISES

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	3416L0300X	Land Ambulance	786	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590013557	OTHER	AR	RAILROAD MEDICARE
2	590013557	OTHER	AL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679572598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARLOCK ENTERPRISES

Provider Business Mailing Address
First Line	:	29 LV STABLER DRIVE
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037
Country	:	US
Telephone Number	:	334-383-9894
Fax Number	:	334-383-2221

Provider Business Practice Location Address
First Line	:	108 LV STABLER DRIVE
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037
Country	:	US
Telephone Number	:	334-383-9908
Fax Number	:	334-383-2221

Authorized Official
Title or Position	:	BILLER
Name	:	MRS. JORICA MARIE PEAVY
Credential	:	BILLER
Telephone Number	:	334-383-9894

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/17/2023

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Directions to “GARLOCK ENTERPRISES ” Practice Location

Language	Start Address	Practice Location

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