Provider Demographics
NPI:1689002701
Name:HEALTHGATES LLC
Entity Type:Organization
Organization Name:HEALTHGATES LLC
Other - Org Name:HEALTHGATES PHARMACY & MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLAJUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-310-2047
Mailing Address - Street 1:9 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2326
Mailing Address - Country:US
Mailing Address - Phone:443-708-3302
Mailing Address - Fax:443-708-3502
Practice Address - Street 1:9 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2326
Practice Address - Country:US
Practice Address - Phone:443-708-3302
Practice Address - Fax:443-708-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP061093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142789OtherPK