MEDICARE: GULF HEALTH HOSPITALS DBA OAKWOOD CENTER FOR LIVING

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	311ZA0620X	Adult Care Home Facility		AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154352524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF HEALTH HOSPITALS DBA OAKWOOD CENTER FOR LIVING

Provider Business Mailing Address
First Line	:	PO BOX 1409
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-1409
Country	:	US
Telephone Number	:	251-580-1717
Fax Number	:	251-937-1657

Provider Business Practice Location Address
First Line	:	2010 MEDICAL CENTER DR
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4163
Country	:	US
Telephone Number	:	251-580-1717
Fax Number	:	251-937-1657

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN EADS
Credential	:
Telephone Number	:	251-580-1717

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/21/2022

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