| Gateway Medical Clinic | |
|
127 E Redstone Ave Ste C Crestview FL 32539-5358 | |
| (850) 423-0061 | |
| Not Available |
| Full Name | Gateway Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 127 E Redstone Ave, Crestview, Florida |
| Authorized Official Name and Position | Paula Lalor (SR. DIRECTOR) |
| Authorized Official Contact | 6292153953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Medical Clinic Po Box 198002 Atlanta GA 30384-8002 Ph: () - | Gateway Medical Clinic 127 E Redstone Ave Ste C Crestview FL 32539-5358 Ph: (850) 423-0061 |
| NPI Number | 1659348712 |
|---|---|
| Provider Enumeration Date | 03/07/2006 |
| Last Update Date | 03/22/2023 |
| Medicare PECOS PAC ID | 3678472313 |
|---|---|
| Medicare Enrollment ID | O20040726000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659348712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | HCC3810 (Florida) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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