Provider Demographics
NPI:1720106958
Name:GATEWAY SONOGRAPHICS, INC.
Entity Type:Organization
Organization Name:GATEWAY SONOGRAPHICS, INC.
Other - Org Name:ALAN F. GREER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:636-464-6670
Mailing Address - Street 1:1115 JAMES DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-2343
Mailing Address - Country:US
Mailing Address - Phone:636-464-6670
Mailing Address - Fax:636-464-6671
Practice Address - Street 1:1115 JAMES DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-2343
Practice Address - Country:US
Practice Address - Phone:636-464-6670
Practice Address - Fax:636-464-6671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL653820Medicare ID - Type Unspecified
MO93036Medicare ID - Type Unspecified