Provider Demographics
NPI:1417353087
Name:GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Entity Type:Organization
Organization Name:GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Other - Org Name:GATEWAY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR PHYSICIAN REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-3641
Mailing Address - Street 1:1573 MALLORY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2895
Mailing Address - Country:US
Mailing Address - Phone:152-221-1400
Mailing Address - Fax:615-465-2877
Practice Address - Street 1:4273 S STATE ROUTE 159
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-3224
Practice Address - Country:US
Practice Address - Phone:618-288-2297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHS/COMMUNITY HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-10
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care