Provider Demographics
NPI:1710033790
Name:GULF HEALTH HOSPITALS
Entity Type:Organization
Organization Name:GULF HEALTH HOSPITALS
Other - Org Name:THOMAS HOSPITAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-990-1510
Mailing Address - Street 1:27961 US HIGHWAY 98
Mailing Address - Street 2:SUITE 16
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4702
Mailing Address - Country:US
Mailing Address - Phone:251-625-1520
Mailing Address - Fax:251-625-1521
Practice Address - Street 1:27961 US HIGHWAY 98
Practice Address - Street 2:SUITE 16
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4702
Practice Address - Country:US
Practice Address - Phone:251-625-1520
Practice Address - Fax:251-625-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL017148Medicare ID - Type Unspecified
AL017148Medicare Oscar/Certification