Organization
GULF COAST MED SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY WAGNER (BILLING MANAGER)
(979) 266-9497
Entity
Organization
Contact information
Practice address
107 W WAY ST STE 20, LAKE JACKSON, TX 77566-5238
(979) 266-9497
(979) 266-9507
Mailing address
107 W WAY ST STE 20, LAKE JACKSON, TX 77566-5238
(979) 266-9497
(979) 266-9507
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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