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General NPI Number Information
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NPI Number | 1508137944
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Entity Type | Organization
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Legal Business Name | GATEWAY HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1007 N BROADWAY
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City | POTEAU
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State | OK
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Zip | 74953-2609
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Country | US
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Telephone | 918-649-0314
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Fax | 918-649-0319
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Provider Business Mailing Address
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Address Line | P.O. BOX 1053
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City | POTEAU
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State | OK
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Zip | 74953
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Country | US
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Telephone | 918-649-0314
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Fax | 918-649-0319
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Authorized Official
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Title or Position | RN/ADMIN/CO-OWNER
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Name | MRS. KATHERINE D YANDELL
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Credential |
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Telephone | 918-649-0314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7973
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License Number State | OK
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