Provider Demographics
NPI:1376982801
Name:GATEWAY EMERGENCY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GATEWAY EMERGENCY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARIMAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:MAMEDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-489-4354
Mailing Address - Street 1:8050 WATSON ROAD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119
Mailing Address - Country:US
Mailing Address - Phone:314-489-4354
Mailing Address - Fax:
Practice Address - Street 1:8050 WATSON RD STE 140
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5337
Practice Address - Country:US
Practice Address - Phone:314-489-4354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1317878341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance