Organization
CRESTVIEW HOSPITAL CORPORATION
Active
Parent organization
CRESTVIEW HOSPITAL CORPORATION
Other names
Gateway Medical Clinic - Defuniak Springs
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRESTVIEW HOSPITAL CORPORATION
Authorized official
PAULA LALOR (SR. DIRECTOR)
(629) 215-3953
Entity
Organization
Contact information
Practice address
1045 US HIGHWAY 331 S STE D, DEFUNIAK SPRINGS, FL 32435-3379
(850) 892-3366
Mailing address
PO BOX 198002, ATLANTA, GA 30384-8002
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
HCC3826
FL
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2006
Last updated
03/21/2022
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