Provider Demographics
NPI:1972188407
Name:GFM MEDICAL SUPPLY AND EQUIPMENT LLC
Entity Type:Organization
Organization Name:GFM MEDICAL SUPPLY AND EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DESTINEE
Authorized Official - Middle Name:MAYESE MONTELL
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-355-3104
Mailing Address - Street 1:6139 GUILDFORD HILL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-1888
Mailing Address - Country:US
Mailing Address - Phone:980-355-3104
Mailing Address - Fax:
Practice Address - Street 1:1018 S CASHUA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6315
Practice Address - Country:US
Practice Address - Phone:980-355-3104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies