Provider Demographics
NPI:1346241692
Name:GILL-WEST COMPANIES, INC.
Entity Type:Organization
Organization Name:GILL-WEST COMPANIES, INC.
Other - Org Name:RIVER VALLEY MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-705-9401
Mailing Address - Street 1:PO BOX 1479
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-1479
Mailing Address - Country:US
Mailing Address - Phone:479-705-9401
Mailing Address - Fax:479-705-8801
Practice Address - Street 1:1112 S ROGERS ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-9157
Practice Address - Country:US
Practice Address - Phone:479-705-9401
Practice Address - Fax:479-705-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00584332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4994180001Medicare ID - Type Unspecified