Provider Demographics
NPI:1780281881
Name:GATEWAY PRESCRIPTION CENTER INC
Entity type:Organization
Organization Name:GATEWAY PRESCRIPTION CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-719-9952
Mailing Address - Street 1:780 SE BAYA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5403
Mailing Address - Country:US
Mailing Address - Phone:376-719-9952
Mailing Address - Fax:386-438-5421
Practice Address - Street 1:742 SE BAYA DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6079
Practice Address - Country:US
Practice Address - Phone:386-755-2277
Practice Address - Fax:386-466-1923
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY PRESCRIPTION CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-02
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies