Provider Demographics
NPI:1700911633
Name:G.B.M. MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:G.B.M. MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MADISON
Authorized Official - Last Name:WOODALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-416-4260
Mailing Address - Street 1:9000 SHERIDAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8802
Mailing Address - Country:US
Mailing Address - Phone:954-416-4260
Mailing Address - Fax:
Practice Address - Street 1:9000 SHERIDAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-8802
Practice Address - Country:US
Practice Address - Phone:954-416-4260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies