Healthcare Provider Details

I. General information

NPI: 1700547023
Provider Name (Legal Business Name): GATEWAY HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2022
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 ROUSCH DR STE 100
MORGANTOWN WV
26501-3872
US

IV. Provider business mailing address

129 E MAIN ST
BRIDGEPORT WV
26330-1706
US

V. Phone/Fax

Practice location:
  • Phone: 833-988-4663
  • Fax: 304-842-1084
Mailing address:
  • Phone: 833-988-4663
  • Fax: 304-842-1084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS BARCELLONA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 304-974-4200