Organization
GATEWAY HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE FACTEAU (CREDENTIALING COORDINATOR)
(401) 724-8400
Entity
Organization
Contact information
Practice address
249 ROOSEVELT AVE, SUITE 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
(401) 365-1100
Mailing address
101 BACON ST, PAWTUCKET, RI 02860-5542
(401) 722-3560
(401) 724-3120
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RN35771
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KH43328
—
RI
Enumeration date
07/10/2006
Last updated
08/22/2020
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