Provider Demographics
NPI:1033437090
Name:G & S MEDICAL, LLC
Entity Type:Organization
Organization Name:G & S MEDICAL, LLC
Other - Org Name:OASIS NECK & BACK CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SCHEREK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-755-1001
Mailing Address - Street 1:1467 W ELLIOT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5167
Mailing Address - Country:US
Mailing Address - Phone:480-755-1001
Mailing Address - Fax:480-755-4703
Practice Address - Street 1:1467 W ELLIOT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5167
Practice Address - Country:US
Practice Address - Phone:480-755-1001
Practice Address - Fax:480-755-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT42113Medicare UPIN
AZ107761Medicare PIN