MEDICARE: OFFICE GEMS BUSINESS AGENCY

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1730031972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OFFICE GEMS BUSINESS AGENCY

Provider Business Mailing Address
First Line	:	318 S SOUTH ST # B9
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28052-4379
Country	:	US
Telephone Number	:	704-565-9151
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 S SOUTH ST # B9
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28052-4379
Country	:	US
Telephone Number	:	704-565-9151
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEWELL WILSON
Credential	:	MBA
Telephone Number	:	704-761-3886

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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