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Organization
GALLANT MEDICAL SUPPLY INC
Active
Organization
GALLANT MEDICAL SUPPLY INC
Active
Other names
GALLANT MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YOUNG DENNIS AHN (PRESIDENT/C.E.O)
(951) 672-4965
Entity
Organization
Contact information
Practice address
27740 ENCANTO DR, SUN CITY, CA 92586-4521
(951) 672-4965
(951) 672-4966
Mailing address
27740 ENCANTO DR, SUN CITY, CA 92586-4521
(951) 672-4965
(951) 672-4966
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
45661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01193G
—
CA
Enumeration date
07/01/2006
Last updated
08/22/2020
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