1497740302 NPI number — G A M S INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497740302 NPI number — G A M S INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G A M S INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MEDICINE SHOPPE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497740302
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2665 BRODHEAD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALIQUIPPA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15001-2723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-375-5561
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2665 BRODHEAD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALIQUIPPA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15001-2723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-375-5561
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TRAVLOS
Authorized Official First Name:
GEORGIA
Authorized Official Middle Name:
VICTORIA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-375-5561

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PP411869L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3958723 . This is a "NCPDP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001172583 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com