Provider Demographics
NPI:1861688624
Name:GLORIA'S LLC
Entity Type:Organization
Organization Name:GLORIA'S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SEIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-387-2022
Mailing Address - Street 1:102 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YALE
Mailing Address - State:MI
Mailing Address - Zip Code:48097-3318
Mailing Address - Country:US
Mailing Address - Phone:810-387-2022
Mailing Address - Fax:810-387-2282
Practice Address - Street 1:102 S MAIN ST
Practice Address - Street 2:
Practice Address - City:YALE
Practice Address - State:MI
Practice Address - Zip Code:48097-3318
Practice Address - Country:US
Practice Address - Phone:810-387-2022
Practice Address - Fax:810-387-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies