Provider Demographics
NPI:1881121556
Name:GULF HEALTH HOSPITAL
Entity type:Organization
Organization Name:GULF HEALTH HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT REP
Authorized Official - Prefix:MISS
Authorized Official - First Name:KERSANDRA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL BILLER
Authorized Official - Phone:251-435-1330
Mailing Address - Street 1:2002 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507
Mailing Address - Country:US
Mailing Address - Phone:251-435-1330
Mailing Address - Fax:
Practice Address - Street 1:2002 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-4163
Practice Address - Country:US
Practice Address - Phone:251-435-1330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty