Organization
GULF COAST MEDICAL TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY BRADFORD (OWNER)
(228) 284-4195
Entity
Organization
Contact information
Practice address
19386 NORTHRIDGE DR, GULFPORT, MS 39503-7600
(228) 284-4195
Mailing address
19386 NORTHRIDGE DR, GULFPORT, MS 39503-7600
(228) 284-4195
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1042141
MS
Other
Enumeration date
06/04/2014
Last updated
07/29/2014
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