Provider Demographics
NPI:1659418754
Name:WEST GATE HOME MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:WEST GATE HOME MEDICAL EQUIPMENT, INC
Other - Org Name:WEST GATE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-775-3339
Mailing Address - Street 1:PO BOX R
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1415
Mailing Address - Country:US
Mailing Address - Phone:508-775-3339
Mailing Address - Fax:508-775-7122
Practice Address - Street 1:87 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2212
Practice Address - Country:US
Practice Address - Phone:508-775-3339
Practice Address - Fax:508-775-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2023-07-27
Deactivation Date:2019-09-11
Deactivation Code:
Reactivation Date:2019-11-04
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1540343Medicaid
4425030001Medicare ID - Type Unspecified