Healthcare Provider Details
I. General information
NPI: 1043978687
Provider Name (Legal Business Name): GOOD HOPE MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2021
Last Update Date: 11/02/2023
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1225 COUNTY ROAD 437
CULLMAN AL
35055
US
IV. Provider business mailing address
1225 COUNTY ROAD 437
CULLMAN AL
35055-0203
US
V. Phone/Fax
- Phone: 706-992-9232
- Fax:
- Phone: 256-615-2055
- Fax: 256-747-5219
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
LINDSAY
HAWKINS
HARRISON
Title or Position: CEO, NP
Credential: NP
Phone: 256-615-2055