Provider Demographics
NPI:1942445143
Name:GEMINI MEDICAL PRODUCTS LLC
Entity Type:Organization
Organization Name:GEMINI MEDICAL PRODUCTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-462-4624
Mailing Address - Street 1:116 HARMON CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8146
Mailing Address - Country:US
Mailing Address - Phone:803-462-4624
Mailing Address - Fax:866-371-7874
Practice Address - Street 1:4265 AUGUSTA RD
Practice Address - Street 2:SUITE O
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-7987
Practice Address - Country:US
Practice Address - Phone:803-462-4624
Practice Address - Fax:866-371-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3187Medicaid
=========OtherBLUE CROSS / BLUE SHIELD
SCDE3187Medicaid