Provider Demographics
NPI:1700020153
Name:G&L COMFORTSHOES INC.
Entity Type:Organization
Organization Name:G&L COMFORTSHOES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GASHGARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER OF CORPORATION
Authorized Official - Phone:814-854-7463
Mailing Address - Street 1:5027 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509
Mailing Address - Country:US
Mailing Address - Phone:814-864-7463
Mailing Address - Fax:814-864-0080
Practice Address - Street 1:5027 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509
Practice Address - Country:US
Practice Address - Phone:814-864-7463
Practice Address - Fax:814-864-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000007364332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6000007364OtherDME