GORDIAN MEDICAL, INC.

Provider Demographics

• NPI: 1013124213
• Name: GORDIAN MEDICAL, INC.
• Entity Type: Organization
• Organization Name: GORDIAN MEDICAL, INC.
• Other - Org Name: AMERICAN MEDICAL TECHNOLOGIES
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - First Name: JEFFREY
• Authorized Official - Last Name: BOWMAN
• Authorized Official - Phone: 714-556-0200
• Mailing Address - Street 1: 750 THE CITY DR S STE 225
• Mailing Address - City: ORANGE
• Mailing Address - State: CA
• Mailing Address - Zip Code: 92868-4976
• Mailing Address - Country: US
• Mailing Address - Phone: 714-556-0200
• Mailing Address - Fax: 877-380-8282
• Practice Address - Street 1: 750 THE CITY DR S STE 225
• Practice Address - City: ORANGE
• Practice Address - State: CA
• Practice Address - Zip Code: 92868-4976
• Practice Address - Country: US
• Practice Address - Phone: 714-556-0200
• Practice Address - Fax: 877-380-8282
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-05-17
• Last Update Date: 2024-02-08

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MD	019107800	Medicaid
DC	057817300	Medicaid
DE	1013124213	Medicaid
ID	1013124213	Medicaid
WI	1013124213	Medicaid
PA	102324539-0001	Medicaid
AL	104474	Medicaid
WY	127642500	Medicaid
LA	1886211	Medicaid
HI	630922	Other	HAWAII - MEDQUEST
HI	00A0284297	Other	MEDICAID - HMSA
HI	1013124213	Medicaid
VA	1013124213	Medicaid
TN	1508028	Medicaid
AR	173356741	Medicaid
OH	2876311	Medicaid
NY	3156521	Medicaid
CT	008097518	Medicaid
NJ	0239631	Medicaid
IL	1013124213	Medicaid
MN	1013124213	Medicaid
MA	110087981A	Medicaid
KS	200570340A	Other	MEDICAID - QMB
SD	9164030	Medicaid
FL	009429200	Medicaid
NE	10025734601	Medicaid
ME	1013124213	Medicaid
WV	1013124213	Medicaid
MT	1013124213	Medicaid
TX	196219301	Medicaid
NC	2449249	Medicaid
NV	250016273	Medicaid
NM	28123387	Medicaid
CA	1013124213	Medicaid
UT	1013124213	Medicaid
KS	200570340B	Other	MEDICAID - MCO
IA	1013124213	Medicaid
AK	1021467	Medicaid
AZ	375389	Medicaid
GA	583748890A	Medicaid
MO	626489801	Medicaid
KY	7100704760	Medicaid
SC	DM1312	Medicaid
MS	06336001	Medicaid
OR	500621516	Medicaid
MI	1013124213FAO	Medicaid
OK	200211020A	Medicaid
IN	200914330A	Medicaid
CO	36420859	Medicaid
RI	GM72832	Medicaid