Organization
GREGORY GLOVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GLOVER (OWNER)
(229) 928-6442
Entity
Organization
Contact information
Practice address
502-F SOUTH LEE ST, AMERICUS, GA 31709
(229) 928-6442
Mailing address
7362 GINGER TEA TRL S, JACKSONVILLE, FL 32244-7094
(904) 352-6426
(904) 527-8059
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
13766
GA
Other
Enumeration date
01/05/2007
Last updated
01/30/2012
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