Provider Demographics
NPI:1346266533
Name:GEMMEL PHARMACY GROUP, INC.
Entity Type:Organization
Organization Name:GEMMEL PHARMACY GROUP, INC.
Other - Org Name:GEMMEL'S HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VANTIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-988-5805
Mailing Address - Street 1:137 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3510
Mailing Address - Country:US
Mailing Address - Phone:909-984-9112
Mailing Address - Fax:909-984-6812
Practice Address - Street 1:137 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3510
Practice Address - Country:US
Practice Address - Phone:909-984-9112
Practice Address - Fax:909-984-6812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100667332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ44884ZMedicaid
CAZZZ44884ZMedicaid