Provider Demographics
NPI:1548769409
Name:GBM DME, LLC
Entity Type:Organization
Organization Name:GBM DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP SALES & OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-666-0508
Mailing Address - Street 1:5499 PERRY DR STE B
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-4827
Mailing Address - Country:US
Mailing Address - Phone:248-666-0508
Mailing Address - Fax:248-666-0504
Practice Address - Street 1:5499 PERRY DR STE B
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-4827
Practice Address - Country:US
Practice Address - Phone:248-666-0508
Practice Address - Fax:248-666-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI332B00000XOtherDME