Organization
GATEWAY ENDOSCOPY CENTER, LP
Active
Other names
Gateway Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE L REED (MEDICARE AUTHORIZED OFFICIAL)
(972) 763-3859
Entity
Organization
Contact information
Practice address
12855 N 40 DR, STE 150, SAINT LOUIS, MO 63141-8657
(314) 336-1130
(314) 336-1136
Mailing address
12855 N 40 DR, STE 150, SAINT LOUIS, MO 63141-8657
(314) 336-1130
(314) 336-1136
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
234-0
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00984819
RAILROAD MEDICARE
MO
Enumeration date
05/11/2010
Last updated
06/03/2015
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