Provider Demographics
NPI:1013199231
Name:GATEWAY AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:GATEWAY AMBULANCE SERVICE LLC
Other - Org Name:YELLOW ENTERPRISE SYSTEMS LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-214-7359
Mailing Address - Street 1:PO BOX 2107
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201
Mailing Address - Country:US
Mailing Address - Phone:502-214-7359
Mailing Address - Fax:502-214-7441
Practice Address - Street 1:1530 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-1302
Practice Address - Country:US
Practice Address - Phone:502-214-7367
Practice Address - Fax:502-214-7441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO189171341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance