Provider Demographics
NPI:1669618658
Name:GULF COAST RESEARCH, LLC
Entity type:Organization
Organization Name:GULF COAST RESEARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHOTELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-757-1084
Mailing Address - Street 1:7049 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4320
Mailing Address - Country:US
Mailing Address - Phone:225-757-1084
Mailing Address - Fax:225-757-0294
Practice Address - Street 1:7049 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4320
Practice Address - Country:US
Practice Address - Phone:225-757-1084
Practice Address - Fax:225-757-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No293D00000XLaboratoriesPhysiological Laboratory