# B & G HARVEST MEDICAL SUPPLY, LLC

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

## Provider details

- **NPI number:** 1417151101
- **Authorized official:** JERRE J. GIBBONS (PRESIDENT)
- **Authorized official phone:** (940) 687-6100

## Contact information

- **Practice address:** 1801 GRANT ST, WICHITA FALLS, TX 76309-3219
- **Practice address phone:** (940) 687-6100
- **Practice address fax:** (940) 687-6102
- **Mailing address:** 1801 GRANT ST, WICHITA FALLS, TX 76309-3219
- **Mailing address phone:** (940) 687-6100
- **Mailing address fax:** (940) 687-6102

## Taxonomy

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

## Other

- **Enumeration date:** 06/14/2007
- **Last updated:** 01/30/2014