Provider Demographics
NPI:1407034986
Name:GAIL H. MCPEAK
Entity Type:Organization
Organization Name:GAIL H. MCPEAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-456-2247
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:WAMEGO
Mailing Address - State:KS
Mailing Address - Zip Code:66547-0269
Mailing Address - Country:US
Mailing Address - Phone:785-456-2247
Mailing Address - Fax:785-456-9230
Practice Address - Street 1:414 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547-1682
Practice Address - Country:US
Practice Address - Phone:785-456-2247
Practice Address - Fax:785-456-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1037-2332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0312360001Medicare NSC