Organization
MOBILE INFIRMARY ASSOCIATION
Active
Other names
MIMC Specialty and Home Infusion Pharmacy, Gulf Health Management Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS MARK NIX (PRESIDENT/CEO)
(251) 625-8454
Entity
Organization
Contact information
Practice address
7101 US HIGHWAY 90, BUILDING B, SUITE B100, DAPHNE, AL 36526-9512
(251) 625-8445
Mailing address
PO BOX 1468, DAPHNE, AL 36526-1468
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302591
—
AL
Enumeration date
12/09/2022
Last updated
03/18/2024
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