Provider Demographics
NPI:1457088858
Name:GATE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:GATE MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:RCP
Authorized Official - Phone:619-737-6219
Mailing Address - Street 1:960 E CHASE AVE APT G
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-7666
Mailing Address - Country:US
Mailing Address - Phone:619-737-6219
Mailing Address - Fax:
Practice Address - Street 1:1685 E MAIN ST STE 202-A
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5225
Practice Address - Country:US
Practice Address - Phone:858-844-8730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies