Organization
GOLDEN GATE MANOR INC
Active
Parent organization
GOLDEN GATE MANOR INC
Other names
GOLDEN GATE MEDICAL SUPPLIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOLDEN GATE MANOR INC
Authorized official
MARK HARRIMAN (PRESIDENT)
(719) 369-6290
Entity
Organization
Contact information
Practice address
612 S UNION AVE, PUEBLO, CO 81004-2244
(719) 924-9932
(719) 696-8548
Mailing address
612 S UNION AVE, PUEBLO, CO 81004-2244
(719) 924-9932
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/02/2021
Last updated
04/02/2021
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