Provider Demographics
NPI:1801046180
Name:NORTHGATE MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:NORTHGATE MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ADEBUKOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEKEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-239-4136
Mailing Address - Street 1:8504 SIX FORKS RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3261
Mailing Address - Country:US
Mailing Address - Phone:919-239-4136
Mailing Address - Fax:
Practice Address - Street 1:8504 SIX FORKS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3261
Practice Address - Country:US
Practice Address - Phone:919-239-4136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01459332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies