Provider Demographics
NPI:1285437319
Name:GAKE, LLC
Entity type:Organization
Organization Name:GAKE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:N
Authorized Official - Last Name:FOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-753-7898
Mailing Address - Street 1:1122 KENILWORTH DR STE 18
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2152
Mailing Address - Country:US
Mailing Address - Phone:443-753-7898
Mailing Address - Fax:443-753-7892
Practice Address - Street 1:1122 KENILWORTH DR STE 18
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2152
Practice Address - Country:US
Practice Address - Phone:443-753-7898
Practice Address - Fax:443-753-7892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy