| Organization Name: | MEDICAL GALLERY, LLC |
| NPI Number: | 1114369907 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RYAN N HELMS (OWNER/MANAGER) |
| Mailing Address: | 217 N Waukesha St Bonifay |
| State: | FL US |
| Postal Code: | 324252245 |
| Phone Number: | 8505476186 |
| Fax Number: | 8558995726 |
| NPI Enumeration Date: | 07/23/2013 |
| NPI Last Update Date: | 08/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |