Healthcare Provider Details

I. General information

NPI: 1770061277
Provider Name (Legal Business Name): SOUTHERN RAPID HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25910 CANAL RD STE D
ORANGE BEACH AL
36561-5016
US

IV. Provider business mailing address

25910 CANAL RD STE D
ORANGE BEACH AL
36561-5016
US

V. Phone/Fax

Practice location:
  • Phone: 251-974-2273
  • Fax:
Mailing address:
  • Phone: 251-974-2273
  • Fax: 251-981-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK CAMERON
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 479-466-3664