GNC Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GNC MEDICAL SUPPLY INC

Practice address

961 1/2 Elmhurst Rd
Des Plaines, IL 60016-5606

Phone

(224) 766-1061

NPI assigned

Jun 13, 2011

Last updated

Jun 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mayur K Patel

Title

President

Phone

(224) 766-1061

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1679868160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 1/2 ELMHURST RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165606",
            "telephone_number": "224-766-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 1/2 ELMHURST RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165606",
            "telephone_number": "224-766-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GNC MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAYUR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-766-1061"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.