Provider Demographics
NPI:1508258450
Name:GALWAY TRADING LLC
Entity Type:Organization
Organization Name:GALWAY TRADING LLC
Other - Org Name:CONNI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERTRAND
Authorized Official - Middle Name:
Authorized Official - Last Name:HAURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-794-0763
Mailing Address - Street 1:13101 W WASHINGTON BLVD
Mailing Address - Street 2:#433
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5131
Mailing Address - Country:US
Mailing Address - Phone:800-794-0763
Mailing Address - Fax:
Practice Address - Street 1:13101 W WASHINGTON BLVD
Practice Address - Street 2:#433
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5131
Practice Address - Country:US
Practice Address - Phone:800-794-0763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201214410215332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies