Provider Demographics
NPI:1558601989
Name:GATEWAY HEALTHCARE SERVICES,LLC.
Entity Type:Organization
Organization Name:GATEWAY HEALTHCARE SERVICES,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-258-3702
Mailing Address - Street 1:5949 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3353
Mailing Address - Country:US
Mailing Address - Phone:614-258-3702
Mailing Address - Fax:614-437-9032
Practice Address - Street 1:680 E MARKET ST
Practice Address - Street 2:SUITE 111
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1614
Practice Address - Country:US
Practice Address - Phone:330-762-8718
Practice Address - Fax:330-762-8719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY HEALTHCARE SERVICES,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-21
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368433OtherHOME HEALTH MEDICARE PROVIDER