Provider Demographics
NPI:1598719577
Name:GPCH-GP, INC.
Entity Type:Organization
Organization Name:GPCH-GP, INC.
Other - Org Name:GARDEN PARK MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAZANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-575-7005
Mailing Address - Street 1:PO BOX 1240
Mailing Address - Street 2:15200 COMMUNITY ROAD
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1240
Mailing Address - Country:US
Mailing Address - Phone:228-575-7000
Mailing Address - Fax:228-575-7114
Practice Address - Street 1:15200 COMMUNITY RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3085
Practice Address - Country:US
Practice Address - Phone:228-575-7000
Practice Address - Fax:228-575-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
473504OtherHEALTHLINK
FL212525100Medicaid
LA1743402Medicaid
MS000020006OtherBCBS
105944200OtherUS DEPT LABOR
MS00220734Medicaid
250123Medicare Oscar/Certification