MEDICARE: GATEWAY HOSPICE DENVER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1528673217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY HOSPICE DENVER LLC

Provider Business Mailing Address
First Line	:	3636 NOBEL DR STE 450
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-1062
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2696 S COLORADO BLVD STE 570
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-5954
Country	:	US
Telephone Number	:	303-747-6377
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL SUOR
Credential	:
Telephone Number	:	858-251-4242

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	04/26/2022

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Directions to “GATEWAY HOSPICE DENVER LLC ” Practice Location

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