| Gateway Regional Medical Center | |
|
2100 Madison Ave Granite City IL 62040-4701 | |
| (618) 798-3000 | |
| (618) 798-3724 |
| Full Name | Gateway Regional Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2100 Madison Ave, Granite City, Illinois |
| Authorized Official Name and Position | Randy Michael Cooper (SVP FINANCE OPERATIONS) |
| Authorized Official Contact | 6152213840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Regional Medical Center Po Box 503706 Saint Louis MO 63150-3706 Ph: () - | Gateway Regional Medical Center 2100 Madison Ave Granite City IL 62040-4701 Ph: (618) 798-3000 |
| NPI Number | 1447221247 |
|---|---|
| Provider Enumeration Date | 01/30/2006 |
| Last Update Date | 09/03/2020 |
| Certification Date | 09/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447221247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0005223 (Illinois) | Primary |
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