# GREAT AMERICAN MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great American Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326774472
- **Authorized official:** JONATHAN CRISMAN (VICE PRESIDENT)
- **Authorized official phone:** (832) 404-6186

## Contact information

- **Practice address:** 2111 FM 1960 RD E STE B, HUMBLE, TX 77338-5229
- **Practice address phone:** (877) 442-6787
- **Practice address fax:** (832) 371-6296
- **Mailing address:** 2111 FM 1960 RD E STE B, HUMBLE, TX 77338-5229
- **Mailing address phone:** (877) 442-6787
- **Mailing address fax:** (832) 371-6296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 07/29/2022
- **Last updated:** 07/29/2022