Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1427194273 |
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| LBN Legal business name | GUM CREEK ENTERPRISES INC | ||||||||||||
| Authorized official | MELISA MASON - (MANAGER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 01/29/2007 | ||||||||||||
| Last updated | 05/03/2011 - About 15 years ago | ||||||||||||
| Identifiers |
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