MEDICARE: INFIRMARY HEALTH URGENT CARE - GULF SHORES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1528328127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFIRMARY HEALTH URGENT CARE - GULF SHORES, P.C.

Provider Business Mailing Address
First Line	:	1140 GULF SHORES PKWY
Second Line	:	SUITE A
City	:	GULF SHORES
State	:	AL
Zip	:	36542-5914
Country	:	US
Telephone Number	:	251-968-2273
Fax Number	:	251-948-4860

Provider Business Practice Location Address
First Line	:	1140 GULF SHORES PKWY
Second Line	:	SUITE A
City	:	GULF SHORES
State	:	AL
Zip	:	36542-5914
Country	:	US
Telephone Number	:	251-968-2273
Fax Number	:	251-948-4860

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JAMES BOYD PUGH
Credential	:
Telephone Number	:	251-435-5737

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	08/15/2012

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