Provider Demographics
NPI:1609532753
Name:ACG MEDICAL SUPPLY INCORPORATED
Entity Type:Organization
Organization Name:ACG MEDICAL SUPPLY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:GAMPHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-463-0737
Mailing Address - Street 1:3100 INDEPENDENCE PKWY STE 318
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-1997
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3100 INDEPENDENCE PKWY STE 318
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-1997
Practice Address - Country:US
Practice Address - Phone:972-463-0737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies