Provider Demographics
NPI:1518417195
Name:GULF HEALTH HOSPITALS, INC.
Entity Type:Organization
Organization Name:GULF HEALTH HOSPITALS, INC.
Other - Org Name:GULF HEALTH MANAGEMENT SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:NIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-625-8454
Mailing Address - Street 1:PO BOX 1468
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-1468
Mailing Address - Country:US
Mailing Address - Phone:251-279-2255
Mailing Address - Fax:251-279-2244
Practice Address - Street 1:750 MORPHY AVE
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1812
Practice Address - Country:US
Practice Address - Phone:251-279-2255
Practice Address - Fax:251-279-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1146673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL195994Medicaid
2164548OtherPK