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Organization

GULFPORT HEALTHCARE LLC

Active
Other names
Gulfport Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
TONI H PARKINSON (AUTHORIZED OFFICIAL)
(601) 709-1408
Entity
Organization

Contact information

Practice address
11240 CANAL RD, GULFPORT, MS 39503-8625
(228) 539-9943
(228) 539-9967
Mailing address
11240 CANAL RD, GULFPORT, MS 39503-8625
(228) 539-9943
(228) 539-9967

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01353022
MS
Enumeration date
02/03/2014
Last updated
06/16/2017
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