Provider Demographics
NPI:1720464118
Name:VERHI INC
Entity Type:Organization
Organization Name:VERHI INC
Other - Org Name:GULF COAST ORTHOTICS AND PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:850-477-4880
Mailing Address - Street 1:824 CREIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-7082
Mailing Address - Country:US
Mailing Address - Phone:850-477-4880
Mailing Address - Fax:850-477-4766
Practice Address - Street 1:28A WALTER MARTIN RD NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-4960
Practice Address - Country:US
Practice Address - Phone:850-226-6378
Practice Address - Fax:850-362-6451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR97335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier