Provider Demographics
NPI:1508887431
Name:GMS VENTURES, INC
Entity Type:Organization
Organization Name:GMS VENTURES, INC
Other - Org Name:GMS MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:V
Authorized Official - Last Name:BAGDASARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-644-7610
Mailing Address - Street 1:1155 N VERMONT AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1728
Mailing Address - Country:US
Mailing Address - Phone:323-644-7610
Mailing Address - Fax:323-644-7620
Practice Address - Street 1:1155 N VERMONT AVE STE 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1728
Practice Address - Country:US
Practice Address - Phone:323-644-7610
Practice Address - Fax:323-644-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45856332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45856OtherDHS RETAIL LICENSE
CA5738840001Medicare NSC