Provider Demographics
NPI:1922456995
Name:GAANDBJ LLC
Entity Type:Organization
Organization Name:GAANDBJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JUDGE-CASTELLINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-342-4456
Mailing Address - Street 1:200 SILVER ST UNIT 110
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-3067
Mailing Address - Country:US
Mailing Address - Phone:413-342-4456
Mailing Address - Fax:
Practice Address - Street 1:200 SILVER ST UNIT 110
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3067
Practice Address - Country:US
Practice Address - Phone:413-342-4456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1097793332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies