MEDICARE: GATEWAY FAMILY HEALTH CLINIC, LTD.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106H00000X	Marriage & Family Therapist
2	111N00000X	Chiropractor
3	207Q00000X	Family Medicine Physician
4	207R00000X	Internal Medicine Physician
5	208000000X	Pediatrics Physician
6	208D00000X	General Practice Physician
7	363A00000X	Physician Assistant
8	363LF0000X	Family Nurse Practitioner
9	367500000X	Certified Registered Nurse Anesthetist
10	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1790772259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY FAMILY HEALTH CLINIC, LTD.

Provider Business Mailing Address
First Line	:	4570 CTY HWY 61
Second Line	:
City	:	MOOSE LAKE
State	:	MN
Zip	:	55767-9401
Country	:	US
Telephone Number	:	218-485-4491
Fax Number	:	218-485-4724

Provider Business Practice Location Address
First Line	:	707 LUNDORFF DR STE 1
Second Line	:
City	:	SANDSTONE
State	:	MN
Zip	:	55072-5099
Country	:	US
Telephone Number	:	320-245-2250
Fax Number	:	320-245-2555

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ERIC P. NIELSEN
Credential	:
Telephone Number	:	218-485-4491

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	05/13/2025

Similar Medicare Providers

1073516647 — DR. BRIDGET M. DEWEY M.D.
Practice Location Address:

707 LUNDORFF DR STE 1
SANDSTONE, MN
55072-5099

Practice Phone: 320-245-2250
Practice Fax: 320-245-2555

1275693301 — HEIDI SUE CAVAGNETTO OTR
Practice Location Address:

705 LUNDORFF DR
SANDSTONE, MN
55072-5099

Practice Phone: 320-245-2211
Practice Fax: 320-245-2359

1316194459 — THRIFTY DRUG STORES INC
Practice Location Address:

707 LUNDORFF DR
SANDSTONE, MN
55072-5099

Practice Phone: 320-245-5500
Practice Fax: 320-245-5123

1154852937 — PINE MEDICAL CENTER
Practice Location Address:

705 LUNDORFF DR
SANDSTONE, MN
55072-5099

Practice Phone: 320-245-2211
Practice Fax:

1972001261 — LOGAN MOLZAHN DPT
Practice Location Address:

705 LUNDORFF DR
SANDSTONE, MN
55072-5099

Practice Phone: 320-245-2211
Practice Fax:

1093283020 — CARRIE SURA
Practice Location Address:

707 LUNDORFF DR STE 2
SANDSTONE, MN
55072-5099

Practice Phone: 320-245-5500
Practice Fax:

Directions to “GATEWAY FAMILY HEALTH CLINIC, LTD. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.