Provider Demographics
NPI:1619313079
Name:GATEWAY PHARMACEUTICAL
Entity Type:Organization
Organization Name:GATEWAY PHARMACEUTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-999-4677
Mailing Address - Street 1:3532 VANN RD
Mailing Address - Street 2:SUITE 106-B
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3262
Mailing Address - Country:US
Mailing Address - Phone:205-508-8800
Mailing Address - Fax:205-508-5501
Practice Address - Street 1:3532 VANN RD
Practice Address - Street 2:SUITE 106-B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3262
Practice Address - Country:US
Practice Address - Phone:205-508-8800
Practice Address - Fax:205-508-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL114110333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy