Provider Demographics
NPI:1487664793
Name:GARYFS, INC
Entity Type:Organization
Organization Name:GARYFS, INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAMKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-634-1600
Mailing Address - Street 1:1347 ENCINITAS BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2845
Mailing Address - Country:US
Mailing Address - Phone:760-634-1600
Mailing Address - Fax:760-634-1616
Practice Address - Street 1:1347 ENCINITAS BLVD
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2845
Practice Address - Country:US
Practice Address - Phone:760-634-1600
Practice Address - Fax:760-634-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4049620001Medicare ID - Type Unspecified