Provider Demographics
NPI:1467697557
Name:GERTHILL MEDICAL SUPPLY
Entity Type:Organization
Organization Name:GERTHILL MEDICAL SUPPLY
Other - Org Name:GERTHILL MEDICAL SUPPLY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERTRUDE
Authorized Official - Middle Name:ULOMA
Authorized Official - Last Name:IHENACHOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-327-6977
Mailing Address - Street 1:825 W GARDENA BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4999
Mailing Address - Country:US
Mailing Address - Phone:310-327-6977
Mailing Address - Fax:310-327-6980
Practice Address - Street 1:825 W GARDENA BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4999
Practice Address - Country:US
Practice Address - Phone:310-327-6977
Practice Address - Fax:310-327-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49345332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies