MEDICARE: MEMORIAL HOSPITAL AT GULFPORT

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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1285070672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HOSPITAL AT GULFPORT

Provider Business Mailing Address
First Line	:	PO BOX 555
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39533-0555
Country	:	US
Telephone Number	:	228-575-1700
Fax Number	:	228-575-1735

Provider Business Practice Location Address
First Line	:	2781 C. T. SWITZER DR.
Second Line	:	SUITE 404
City	:	BILOXI
State	:	MS
Zip	:	39531-4535
Country	:	US
Telephone Number	:	228-865-3030
Fax Number	:

Authorized Official
Title or Position	:	VP OF FINANCE
Name	:	MR. JEFF T STEINER
Credential	:
Telephone Number	:	228-865-3030

Provider Enumeration Date	:	05/13/2013
Last Update Date	:	05/13/2013

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