Provider Demographics
NPI:1679853642
Name:GATEWAY COMMUNITY HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:GATEWAY COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:GATEWAY COMMUNITY HEALTH CENTERS, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-506-7000
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:501 MAIN STREET
Mailing Address - City:GATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27938-9424
Mailing Address - Country:US
Mailing Address - Phone:252-357-1226
Mailing Address - Fax:252-357-1236
Practice Address - Street 1:2869 VIRGINIA RD
Practice Address - Street 2:
Practice Address - City:TYNER
Practice Address - State:NC
Practice Address - Zip Code:27980-9777
Practice Address - Country:US
Practice Address - Phone:252-506-7000
Practice Address - Fax:252-357-1236
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY COMMUNITY HEALTH CENTERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-23
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty