Provider Demographics
NPI:1417833682
Name:CG MEDICAL SUPPLIES CORP
Entity type:Organization
Organization Name:CG MEDICAL SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTRANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-264-5756
Mailing Address - Street 1:520 N CAMINO MERCADO STE 11
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5754
Mailing Address - Country:US
Mailing Address - Phone:833-948-2409
Mailing Address - Fax:833-463-8196
Practice Address - Street 1:520 N CAMINO MERCADO STE 11
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5754
Practice Address - Country:US
Practice Address - Phone:833-948-2409
Practice Address - Fax:833-463-8196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies