MEDICARE: GATEWAY MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QP2300X	Primary Care Clinic/Center
4	261QU0200X	Urgent Care Clinic/Center
5	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1447070685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	3433 AGLER RD STE 1100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3390
Country	:	US
Telephone Number	:	914-708-6574
Fax Number	:

Provider Business Practice Location Address
First Line	:	3433 AGLER RD STE 1100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3390
Country	:	US
Telephone Number	:	914-708-6574
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	CHARLES OKYERE
Credential	:
Telephone Number	:	914-708-6574

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	12/16/2024

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Directions to “GATEWAY MEDICAL CENTER LLC ” Practice Location

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