Provider Demographics
NPI:1760512057
Name:BEEBE MEDICAL CENTER - GULL HOUSE
Entity Type:Organization
Organization Name:BEEBE MEDICAL CENTER - GULL HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT BUSINESS SVX
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:KESTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:302-645-3210
Mailing Address - Street 1:424 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1462
Mailing Address - Country:US
Mailing Address - Phone:302-226-2160
Mailing Address - Fax:302-226-2161
Practice Address - Street 1:38149 TERRACE RD
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-2074
Practice Address - Country:US
Practice Address - Phone:302-226-2160
Practice Address - Fax:302-226-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000565455385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000565455Medicaid