Provider Demographics
NPI:1821168659
Name:G-5 ENTERPRISES INC
Entity Type:Organization
Organization Name:G-5 ENTERPRISES INC
Other - Org Name:MEDICAL HOME HEALTH AND MOBILITY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-784-4787
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28026-0248
Mailing Address - Country:US
Mailing Address - Phone:704-784-4787
Mailing Address - Fax:704-788-6603
Practice Address - Street 1:809 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4333
Practice Address - Country:US
Practice Address - Phone:704-784-4787
Practice Address - Fax:704-788-6603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:G5 ENTERPRISES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-09
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0426VOtherBCBS OF NC ID
NC7701978Medicaid
SCDE1467Medicaid
NC0426VOtherBCBS OF NC ID