Organization
GATE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN ALLEN THORNTON JR. RCP (PRESIDENT)
(619) 737-6219
Entity
Organization
Contact information
Practice address
1685 E MAIN ST STE 202-A, EL CAJON, CA 92021-5225
(858) 844-8730
Mailing address
960 E CHASE AVE APT G, EL CAJON, CA 92020-7666
(619) 737-6219
Taxonomy
Speciality
Code
Description
License number
State
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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