Provider Demographics
NPI:1821391624
Name:CGL HEALTHCARE LLC
Entity Type:Organization
Organization Name:CGL HEALTHCARE LLC
Other - Org Name:INHEALTH MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-230-5632
Mailing Address - Street 1:2551 TEXAS AVE S
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-5044
Mailing Address - Country:US
Mailing Address - Phone:979-696-0261
Mailing Address - Fax:979-696-0278
Practice Address - Street 1:2551 TEXAS AVE S
Practice Address - Street 2:SUITE A
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-5044
Practice Address - Country:US
Practice Address - Phone:979-696-0261
Practice Address - Fax:979-696-0278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001108332BX2000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies