Provider Demographics
NPI:1104389972
Name:GWG HEALTHCARE INC.
Entity Type:Organization
Organization Name:GWG HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-200-2770
Mailing Address - Street 1:1211 HAMBURG TPKE STE 215
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5040
Mailing Address - Country:US
Mailing Address - Phone:973-200-2770
Mailing Address - Fax:973-400-0045
Practice Address - Street 1:1211 HAMBURG TPKE STE 215
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5040
Practice Address - Country:US
Practice Address - Phone:973-200-2770
Practice Address - Fax:973-400-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health