Provider Demographics
NPI:1003446790
Name:DRGMED, INC.
Entity type:Organization
Organization Name:DRGMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-450-9651
Mailing Address - Street 1:1420 NW 15TH AVE APT 801
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-2974
Mailing Address - Country:US
Mailing Address - Phone:305-450-9651
Mailing Address - Fax:305-418-7511
Practice Address - Street 1:400 GOLD AVE SW STE 1060
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3263
Practice Address - Country:US
Practice Address - Phone:305-450-9651
Practice Address - Fax:305-418-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108764100Medicaid