GD Life Supply Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

GD LIFE SUPPLY INC

Practice address

1051 County Line Rd
Suite 104
Huntingdon Valley, PA 19006-1229

Phone

(215) 322-7057

NPI assigned

Feb 25, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Glen Primak

Title

President

Phone

(215) 915-5700

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1316244403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 COUNTY LINE RD",
            "address_2": "SUITE 104",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190061229",
            "telephone_number": "215-322-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 COUNTY LINE RD",
            "address_2": "SUITE 104",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190061229",
            "telephone_number": "215-322-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD LIFE SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "PRIMAK",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-915-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Galloway, PHARM.D.
• Brian Gantt
• Erin Garrard, MS, BCBA, LBS
• Elizabeth Gasiewski, PH.D.
• Gayle L Gates, LPC
• Geeta Vaze MD PC
• Susanna Gelman, PHARMD
• Gem Home Care, Inc.
• Gene Linetsky,DPM,PC
• Bruce Eric Genter, M.D.

• Customized Equipment (DME) in Huntingdon Valley, PA
• Providers in Huntingdon Valley, PA by specialty
• Customized Equipment (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.