Provider Demographics
NPI:1043978687
Name:GOOD HOPE MEDICAL INC
Entity Type:Organization
Organization Name:GOOD HOPE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:HAWKINS
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:256-615-2055
Mailing Address - Street 1:1225 COUNTY ROAD 437
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-0203
Mailing Address - Country:US
Mailing Address - Phone:256-615-2055
Mailing Address - Fax:256-747-5219
Practice Address - Street 1:1225 COUNTY ROAD 437
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055
Practice Address - Country:US
Practice Address - Phone:706-992-9232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1447697016OtherLINDSAY HARRISON