NPIMap

Organization Active NPI

Golden Gate Manor Inc

Doing business as Golden Gate Medical Supplies

  • Durable Medical Equipment & Medical Supplies
  • Pueblo, CO
National Provider Identifier
1437738093
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GOLDEN GATE MANOR INC
Doing business as
Golden Gate Medical Supplies
Practice address
612 S Union Ave
Pueblo, CO 81004-2244
Phone
(719) 924-9932
Fax
(719) 696-8548
NPI assigned
Apr 2, 2021
Last updated
Apr 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GOLDEN GATE MANOR INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Harriman
Title
President
Phone
(719) 369-6290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

612 S Union Ave
Pueblo, CO 81004-2244

Mailing address

612 S Union Ave
Pueblo, CO 81004-2244
Phone (719) 924-9932

Other names 1

  • GOLDEN GATE MEDICAL SUPPLIES Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.goldengatemanor.com/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211008000399 CO DME Supplier - Medical Supply Company 5395143176 Practice locations: Pueblo, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Golden Gate Manor, Inc612 S Union Ave, Pueblo, CO 81004-2244(719) 696-8032 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Infrared Heating Pads Systems and/or Supplies|Neuromuscular Elect Stimulators (NMES)/Supplies|Pneumatic C… Does not accept assignmentParticipating since Oct 7, 2021

National Provider Directory

National Provider Directory
Tax ID family
Golden Gate Manor Inc5 organizations share this tax ID, including this one
Part of
Golden Gate Manor Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

612 S Union Ave
Pueblo, CO 81004
Phone (719) 696-8032

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1437738093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S UNION AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042244",
            "telephone_number": "719-924-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S UNION AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042244",
            "telephone_number": "719-924-9932",
            "fax_number": "719-696-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN GATE MANOR INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOLDEN GATE MANOR INC",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "HARRIMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-369-6290"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.goldengatemanor.com/",
            "affiliation": "N",
            "endpointDescription": "BUSINESS LOCATION",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "612 UNION AVE, PUEBLO CO 81004-2244, US",
            "address_1": "612 S Union Ave",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810042244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GOLDEN GATE MEDICAL SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.