# GATEWAY MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457974156
- **Authorized official:** UCHE UKEAGU DC (CEO)
- **Authorized official phone:** (954) 415-5931

## Contact information

- **Practice address:** 1108 NEW YORK AVE UNIT 1, SAINT CLOUD, FL 34769-3701
- **Practice address phone:** (407) 337-5112
- **Practice address fax:** (407) 337-5113
- **Mailing address:** 5351 COSTA DEL SOL DR, SAINT CLOUD, FL 34771-7561
- **Mailing address phone:** (954) 415-5931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 05/28/2020
- **Last updated:** 08/16/2020