# GINA CROSSWHITE MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114808474
- **Authorized official:** MR. GINA L CROSSWHITE (CEO)
- **Authorized official phone:** (678) 810-1069

## Contact information

- **Practice address:** 1425 SOTO ST, SEASIDE, CA 93955-5133
- **Practice address phone:** (678) 810-1069
- **Mailing address:** 1425 SOTO ST, SEASIDE, CA 93955-5133
- **Mailing address phone:** (678) 810-1069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 09/11/2025
- **Last updated:** 09/11/2025