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General NPI Number Information
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NPI Number | 1700140795
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Entity Type | Organization
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Legal Business Name | GULF COAST PATIENT CARE NETWORK, INC
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 3280 DAUPHIN ST BUILDING C, SUITE 115
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City | MOBILE
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State | AL
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Zip | 36606-4060
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Country | US
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Telephone | 251-709-8998
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 DAUPHIN ST BUILDING C, SUITE 115
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City | MOBILE
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State | AL
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Zip | 36606-4060
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Country | US
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Telephone | 251-709-8998
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LAURA M. O'CONNOR
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Credential | MHHA
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Telephone | 251-709-8998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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