Provider Demographics
NPI:1114009701
Name:GTGIF, LLC
Entity Type:Organization
Organization Name:GTGIF, LLC
Other - Org Name:CARNIVAL FOODS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-687-1495
Mailing Address - Street 1:1215 N MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1626
Mailing Address - Country:US
Mailing Address - Phone:740-474-2188
Mailing Address - Fax:
Practice Address - Street 1:120 MORRIS RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1362
Practice Address - Country:US
Practice Address - Phone:740-474-2188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0214205503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy