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General NPI Number Information
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NPI Number | 1447070685
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Entity Type | Organization
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Legal Business Name | GATEWAY MEDICAL CENTER LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 3433 AGLER RD STE 1100
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City | COLUMBUS
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State | OH
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Zip | 43219-3390
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Country | US
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Telephone | 914-708-6574
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Fax |
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Provider Business Mailing Address
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Address Line | 3433 AGLER RD STE 1100
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City | COLUMBUS
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State | OH
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Zip | 43219-3390
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Country | US
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Telephone | 914-708-6574
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | CHARLES OKYERE
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Credential |
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Telephone | 914-708-6574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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