Provider Demographics
NPI:1316360258
Name:GULF COAST PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:GULF COAST PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINNACIAL POSITION
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-863-7971
Mailing Address - Street 1:12107 MAJESTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-2455
Mailing Address - Country:US
Mailing Address - Phone:727-863-7971
Mailing Address - Fax:727-819-8571
Practice Address - Street 1:12107 MAJESTIC BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2455
Practice Address - Country:US
Practice Address - Phone:727-863-7971
Practice Address - Fax:727-819-8571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty