Kingsgate Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1000013 Issued in TX

Legal business name

KINGSGATE MEDICAL SUPPLY, LLC

Practice address

1117 W Pioneer Pkwy
Suite 120
Arlington, TX 76013-6395

Phone

(817) 275-1950

Fax

(817) 275-1895

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Abiodun A Badejo

Title

General Manager

Phone

(817) 275-1950

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1538301080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 W PIONEER PKWY",
            "address_2": "SUITE 120",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136395",
            "telephone_number": "817-275-1950",
            "fax_number": "817-275-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 W PIONEER PKWY",
            "address_2": "SUITE 120",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136395",
            "telephone_number": "817-275-1950",
            "fax_number": "817-275-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSGATE MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "BADEJO",
        "authorized_official_first_name": "ABIODUN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "817-275-1950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1000013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illya King, L.V.N.
• Jeff Alan King, D.C.
• Lillian Kenani King
• Mary King
• Michael King, DMD
• Rachel Foster Kingston, PT, DPT
• Jessica Kinney
• Rhonda Kinney, MA
• Diana Kipchilat
• Mark B Kipp, MD

• Durable Medical Equipment & Medical Supplies in Arlington, TX
• Providers in Arlington, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.