Organization
GD LIFE SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN PRIMAK (PRESIDENT)
(215) 915-5700
Entity
Organization
Contact information
Practice address
1051 COUNTY LINE RD, SUITE 104, HUNTINGDON VALLEY, PA 19006-1229
(215) 322-7057
Mailing address
1051 COUNTY LINE RD, SUITE 104, HUNTINGDON VALLEY, PA 19006-1229
(215) 322-7057
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
02/25/2011
Last updated
05/11/2011
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