Provider Demographics
NPI:1982948428
Name:GAMMA HEALTHCARE, INC
Entity Type:Organization
Organization Name:GAMMA HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-727-5607
Mailing Address - Street 1:1717 W MAUD ST
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-4003
Mailing Address - Country:US
Mailing Address - Phone:573-727-5600
Mailing Address - Fax:573-785-0753
Practice Address - Street 1:820 S THREE NOTCH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5359
Practice Address - Country:US
Practice Address - Phone:334-222-2485
Practice Address - Fax:334-222-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory