Provider Demographics
NPI:1194923896
Name:GATEWAY HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:GATEWAY HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-697-1415
Mailing Address - Street 1:6100 CHANNINGWAY BLVD
Mailing Address - Street 2:SUITE 706
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2910
Mailing Address - Country:US
Mailing Address - Phone:614-258-3702
Mailing Address - Fax:614-437-9032
Practice Address - Street 1:6100 CHANNINGWAY BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2910
Practice Address - Country:US
Practice Address - Phone:614-258-3702
Practice Address - Fax:614-437-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368236OtherMEDICARE HOME CARE PROVIDER