Provider Demographics
NPI:1750359485
Name:GALVESTON MEDICAL SUPPLIES, INC
Entity type:Organization
Organization Name:GALVESTON MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-763-0544
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77553-0869
Mailing Address - Country:US
Mailing Address - Phone:409-763-0544
Mailing Address - Fax:409-763-8511
Practice Address - Street 1:711 25TH ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-2101
Practice Address - Country:US
Practice Address - Phone:409-763-0544
Practice Address - Fax:409-763-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX518980OtherBLUE CROSS BLUE SHIELD
TX518980OtherBLUE CROSS BLUE SHIELD