Provider Demographics
NPI:1073736450
Name:GAC & ASSOCIATES INC
Entity Type:Organization
Organization Name:GAC & ASSOCIATES INC
Other - Org Name:GAC MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT OWNER
Authorized Official - Phone:410-225-9515
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:GAC & ASSOCIATES INC
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-0678
Mailing Address - Country:US
Mailing Address - Phone:410-225-9515
Mailing Address - Fax:410-225-9516
Practice Address - Street 1:920 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3940
Practice Address - Country:US
Practice Address - Phone:410-225-9515
Practice Address - Fax:410-225-9516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD381100000Medicaid
MD381100000Medicaid