=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548062177
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GATEWAY COMMUNITY HEALTH CENTERS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2025
-----------------------------------------------------
Last Update Date | 03/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1134 N ROAD ST
-----------------------------------------------------
City | ELIZABETH CITY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27909-3322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-333-1047
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 297
-----------------------------------------------------
City | GATESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27938-0297
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-357-1226
-----------------------------------------------------
Fax | 252-357-1236
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ROSE M TURNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-357-1226
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------