Provider Demographics
NPI:1245941269
Name:GULPER LLC
Entity type:Organization
Organization Name:GULPER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOCUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-706-2476
Mailing Address - Street 1:4320 WINFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4023
Mailing Address - Country:US
Mailing Address - Phone:630-300-3738
Mailing Address - Fax:
Practice Address - Street 1:5015 PRAIRIE SAGE LN
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4326
Practice Address - Country:US
Practice Address - Phone:616-706-2476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies