GTL, INCORPORATED

Provider Demographics

• NPI: 1174681324
• Name: GTL, INCORPORATED
• Entity Type: Organization
• Organization Name: GTL, INCORPORATED
• Other - Org Name: LINK TO LIFE
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: CONTRACTS ADMINISTRATOR
• Authorized Official - First Name: JENNIFER
• Authorized Official - Last Name: THOMPSON
• Authorized Official - Phone: 888-557-4462
• Mailing Address - Street 1: 27475 MEADOWBROOK RD
• Mailing Address - City: NOVI
• Mailing Address - State: MI
• Mailing Address - Zip Code: 48377-3532
• Mailing Address - Country: US
• Mailing Address - Phone: 888-557-4462
• Mailing Address - Fax: 800-325-5145
• Practice Address - Street 1: 27475 MEADOWBROOK RD
• Practice Address - City: NOVI
• Practice Address - State: MI
• Practice Address - Zip Code: 48377-3532
• Practice Address - Country: US
• Practice Address - Phone: 888-557-4462
• Practice Address - Fax: 800-325-5145
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-12-04
• Last Update Date: 2017-07-28

Provider Licenses

State	License ID	Taxonomies
		146D00000X, 332BC3200X, 332B00000X
MI	3601205334	333300000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies
No	146D00000X	Emergency Medical Service Providers	Personal Emergency Response Attendant		Group - Single Specialty
No	332BC3200X	Suppliers	Durable Medical Equipment & Medical Supplies	Customized Equipment
Yes	333300000X	Suppliers	Emergency Response System Companies

Provider Identifiers

State	Identifier ID	ID Type	Issuer
ID	8073901	Medicaid
NY	01293970	Medicaid
GA	000439524B	Medicaid
VT	047W228	Medicaid
OR	232406	Medicaid
OH	2596285	Medicaid
CT	3135713	Medicaid
WA	342496WA	Medicaid
PA	0016336170004	Medicaid
DC	0347403	Medicaid
NJ	05-800-00	Medicaid
MD	1274040-00	Medicaid
ME	432150800	Medicaid
ID	807390100	Medicaid
DE	0000066755	Medicaid
AZ	943340	Medicaid
MA	000000023632	Medicaid
VA	009120181	Medicaid
KS	100377780A	Medicaid
OK	100791920A	Medicaid
IN	200173840A	Medicaid
NH	30594074	Medicaid
IL	EHR1100208	Medicaid
TN	0445827	Medicaid
MT	1174681324	Medicaid
NM	000D3036	Medicaid
PA	0016336170002	Medicaid
MA	1538896	Medicaid
MN	462467000	Medicaid