Provider Demographics
NPI:1336720549
Name:GOLDEN GATES HOSPICE DME, LLC
Entity Type:Organization
Organization Name:GOLDEN GATES HOSPICE DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-247-1090
Mailing Address - Street 1:1100 RIO VERDE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-7200
Mailing Address - Country:US
Mailing Address - Phone:214-335-7563
Mailing Address - Fax:
Practice Address - Street 1:4041 W WHEATLAND RD STE 166
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-4061
Practice Address - Country:US
Practice Address - Phone:214-247-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies