Provider Demographics
NPI:1780200493
Name:GEM FOOTCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:GEM FOOTCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ALLDREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-236-5937
Mailing Address - Street 1:PO BOX 3572
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-0572
Mailing Address - Country:US
Mailing Address - Phone:256-236-5937
Mailing Address - Fax:
Practice Address - Street 1:301 S QUINTARD AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-6071
Practice Address - Country:US
Practice Address - Phone:256-236-5937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies