Organization
GERIATRIC SERVICES OF AMERICA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY RHEAULT (CEO)
(480) 967-9203
Entity
Organization
Contact information
Practice address
5030 S MILL AVE, SUITE D-23, TEMPE, AZ 85282-6833
(480) 967-9203
Mailing address
PO BOX 13034, TEMPE, AZ 85284-0051
(480) 967-9203
(480) 838-6920
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
2455
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251178-00
—
NE
05
—
200020690B
—
OK
05
—
90009796
—
KY
Enumeration date
09/13/2006
Last updated
05/02/2008
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