MEDICARE: GATEWAY BUILDING SUPPLY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171WH0202X	Home Modifications Contractor		IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457539215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY BUILDING SUPPLY INC

Provider Business Mailing Address
First Line	:	8515 DOUGLAS AVE STE 15
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-2924
Country	:	US
Telephone Number	:	515-249-3083
Fax Number	:	515-251-4817

Provider Business Practice Location Address
First Line	:	8515 DOUGLAS AVE STE 15
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-2924
Country	:	US
Telephone Number	:	515-249-3083
Fax Number	:	515-251-4817

Authorized Official
Title or Position	:	OWNER
Name	:	MR. HOSSEIN ALAVI
Credential	:
Telephone Number	:	515-249-3083

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	07/21/2022

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Directions to “GATEWAY BUILDING SUPPLY INC ” Practice Location

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