Provider Demographics
NPI:1740569938
Name:GILEAD MEDICAL LLC
Entity type:Organization
Organization Name:GILEAD MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA PERRYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-562-8796
Mailing Address - Street 1:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-0892
Mailing Address - Country:US
Mailing Address - Phone:419-562-8796
Mailing Address - Fax:419-562-6807
Practice Address - Street 1:512 HILL ST
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-1554
Practice Address - Country:US
Practice Address - Phone:419-562-8796
Practice Address - Fax:419-562-6807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty