Organization
CRESTVIEW HOSPITAL COMPANY, LLC
Active
Parent organization
CRESTVIEW HOSPITAL COMPANY, LLC
Other names
Gateway Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRESTVIEW HOSPITAL COMPANY, LLC
Authorized official
PAULA LALOR (SR. DIRECTOR)
(629) 215-3953
Entity
Organization
Contact information
Practice address
127 E REDSTONE AVE, STE C, CRESTVIEW, FL 32539-5358
(850) 423-0061
Mailing address
PO BOX 198002, ATLANTA, GA 30384-8002
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
HCC3810
FL
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2006
Last updated
03/22/2023
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