MEDICARE: GATE WAY HEALTH CARE ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447443098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATE WAY HEALTH CARE ASSOCIATES

Provider Business Mailing Address
First Line	:	612 E DR MARTIN LUTHER KING JR DR
Second Line	:
City	:	MAXTON
State	:	NC
Zip	:	28364-1800
Country	:	US
Telephone Number	:	191-084-4269
Fax Number	:	191-084-4269

Provider Business Practice Location Address
First Line	:	612 E DR MARTIN LUTHER KING JR DR
Second Line	:	612 MARTIN LUTHER KING DRIVE
City	:	MAXTON
State	:	NC
Zip	:	28364-1800
Country	:	US
Telephone Number	:	910-844-2693
Fax Number	:	910-844-2694

Authorized Official
Title or Position	:	OWNER
Name	:	MS. EALISE HUNT
Credential	:
Telephone Number	:	19108442693

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	11/03/2009

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Practice Location Address:

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1093974396 — GATE WAY HEALTH CARE ASSOCIATES LLC
Practice Location Address:

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28364-1800

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Practice Fax: 910-844-2694

Directions to “GATE WAY HEALTH CARE ASSOCIATES ” Practice Location

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