Provider Demographics
NPI:1720772858
Name:MY 3 GIBBYS CORP
Entity Type:Organization
Organization Name:MY 3 GIBBYS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-340-0100
Mailing Address - Street 1:414 HUNGERFORD DR STE 448
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5118
Mailing Address - Country:US
Mailing Address - Phone:301-340-0100
Mailing Address - Fax:
Practice Address - Street 1:340 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4887
Practice Address - Country:US
Practice Address - Phone:240-651-5876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORT KEEPERS OF ROCKVILLE MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care