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General NPI Number Information
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NPI Number | 1699409581
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Entity Type | Organization
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Legal Business Name | GATEWAY TRANSPORTATION LLC
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 4600 N M 37 HWY STE 100
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-8806
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Country | US
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Telephone | 269-205-2618
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 N M 37 HWY STE 100
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-8806
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Country | US
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Telephone | 269-205-2618
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | TYLER J WUSTMAN
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Credential |
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Telephone | 269-509-1541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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