Provider Demographics
NPI:1013775741
Name:GLOW GLEAM INC
Entity Type:Organization
Organization Name:GLOW GLEAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-972-6235
Mailing Address - Street 1:3220 BUNKER HILL RD APT 2421
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-5027
Mailing Address - Country:US
Mailing Address - Phone:469-972-6235
Mailing Address - Fax:
Practice Address - Street 1:3220 BUNKER HILL RD APT 2421
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-5027
Practice Address - Country:US
Practice Address - Phone:469-972-6235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies