Provider Demographics
NPI:1497740302
Name:G A M S INC
Entity Type:Organization
Organization Name:G A M S INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:TRAVLOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:724-375-5561
Mailing Address - Street 1:2665 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2723
Mailing Address - Country:US
Mailing Address - Phone:724-375-5561
Mailing Address - Fax:
Practice Address - Street 1:2665 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2723
Practice Address - Country:US
Practice Address - Phone:724-375-5561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411869L333600000X
PA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3958723OtherNCPDP #
PA001172583Medicaid
PA001172583Medicaid
PA0129160001Medicare NSC