Organization
GULF STATES MOBILITY AND REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIS GEROUX ATP (MAJORITY STOCKHOLDER)
(662) 418-1328
Entity
Organization
Contact information
Practice address
511 ULMAN AVE, BAY ST LOUIS, MS 39520-3524
(504) 251-1492
Mailing address
219 N BEACH BLVD, WAVELAND, MS 39576-4204
(662) 418-1328
(229) 467-8402
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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