Organization Name: | STARGATE MOBILITY |
NPI Number: | 1144334715 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFERIE A DODGE (OWNER) |
Mailing Address: | 500 S Sunset Ave Roswell |
State: | NM US |
Postal Code: | 882032866 |
Phone Number: | 5752080056 |
Fax Number: | 5052169380 |
NPI Enumeration Date: | 08/19/2006 |
NPI Last Update Date: | 12/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 03065376002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |