Provider Demographics
NPI:1346532603
Name:GULF COAST DME, INC.
Entity Type:Organization
Organization Name:GULF COAST DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASH
Authorized Official - Middle Name:PAL
Authorized Official - Last Name:MEHNDIRATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-912-4683
Mailing Address - Street 1:15200 SHADY GROVE RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3218
Mailing Address - Country:US
Mailing Address - Phone:240-912-4683
Mailing Address - Fax:240-912-4695
Practice Address - Street 1:15200 SHADY GROVE RD
Practice Address - Street 2:SUITE 401
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:240-912-4683
Practice Address - Fax:240-912-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies