Provider Demographics
NPI:1619411725
Name:G A P LIGHTHOUSE MEDICAL EQUIPMENT AND REPAIRS
Entity Type:Organization
Organization Name:G A P LIGHTHOUSE MEDICAL EQUIPMENT AND REPAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-627-5570
Mailing Address - Street 1:5504 BANDERA RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:LEON VALLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1943
Mailing Address - Country:US
Mailing Address - Phone:210-627-5570
Mailing Address - Fax:210-807-9664
Practice Address - Street 1:5504 BANDERA RD
Practice Address - Street 2:SUITE 601
Practice Address - City:LEON VALLEY
Practice Address - State:TX
Practice Address - Zip Code:78238-1943
Practice Address - Country:US
Practice Address - Phone:210-627-5570
Practice Address - Fax:210-807-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-08
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies