Organization
GULF COAST INFUSION LLC
Active
Other names
Vital Care of Pensacola
Organization subpart
No
Provider details
NPI number
Authorized official
TIM MIXON (OWNER)
(251) 947-5593
Entity
Organization
Contact information
Practice address
6565 N W ST STE 220&230, PENSACOLA, FL 32505-1715
(850) 985-8912
(850) 985-8913
Mailing address
6565 N W ST STE 220&230, PENSACOLA, FL 32505-1715
(850) 985-8912
(850) 985-8913
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
02/23/2024
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