Provider Demographics
NPI:1578070009
Name:GEM ENTERPRISES
Entity Type:Organization
Organization Name:GEM ENTERPRISES
Other - Org Name:GEM ENTERPRISES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SNERICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NICKELBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-566-5441
Mailing Address - Street 1:2218 GENERAL TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4772
Mailing Address - Country:US
Mailing Address - Phone:601-566-5441
Mailing Address - Fax:
Practice Address - Street 1:2218 GENERAL TAYLOR DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4772
Practice Address - Country:US
Practice Address - Phone:601-566-5441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based