Organization
G&M PROVISIONS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STARR LYNN PUCKETT (OWNER)
(276) 701-1386
Entity
Organization
Contact information
Practice address
7606 GREEN VALLEY ROAD, LEBANON, VA 24266
(276) 701-1386
Mailing address
PO BOX 1913, LEBANON, VA 24266-1913
(276) 701-1386
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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