Provider Demographics
NPI:1033136957
Name:GSTS DESIGNS, LLC
Entity Type:Organization
Organization Name:GSTS DESIGNS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-427-8765
Mailing Address - Street 1:2075 BALD HILL LOOP
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-7627
Mailing Address - Country:US
Mailing Address - Phone:336-427-8765
Mailing Address - Fax:336-427-6969
Practice Address - Street 1:2075 BALD HILL LOOP
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-7627
Practice Address - Country:US
Practice Address - Phone:336-427-8765
Practice Address - Fax:336-427-6969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00674332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009110569Medicaid
NC4515480001Medicare ID - Type UnspecifiedMIDICARE SUPPLIER NUMBER