Healthcare Provider Details

I. General information

NPI: 1487572681
Provider Name (Legal Business Name): HIGHGATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MOUNTAIN ROAD PL NE STE R
ALBUQUERQUE NM
87110-7825
US

IV. Provider business mailing address

1209 MOUNTAIN ROAD PL NE STE R
ALBUQUERQUE NM
87110-7825
US

V. Phone/Fax

Practice location:
  • Phone: 505-207-6944
  • Fax:
Mailing address:
  • Phone: 505-207-6944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: VIVIAN PYNES
Title or Position: OWNER
Credential:
Phone: 505-207-6944