# HANCOCK HEALTH GATEWAY SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gateway Immediate Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649749052
- **Authorized official:** STEVEN LONG (CEO)
- **Authorized official phone:** (317) 468-4412

## Contact information

- **Practice address:** 6189 JOHN L. MODGLIN DR, SUITE 101, GREENFIELD, IN 46140-9364
- **Practice address phone:** (317) 866-7300
- **Mailing address:** 6189 W JOHN L. MODGLIN DR, SUITE 101, GREENFIELD, IN 46140-9364
- **Mailing address phone:** (317) 866-7300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/14/2018
- **Last updated:** 06/25/2019