Organization
GULF COAST REHAB EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER JOHNSON (MANAGER OF CREDENTIALAND LICENSURE)
(314) 447-7515
Entity
Organization
Contact information
Practice address
2712 7TH AVE S, BIRMINGHAM, AL 35233-3406
(251) 666-1055
(251) 666-8661
Mailing address
805 BROOK ST STE 402, ROCKY HILL, CT 06067-3431
(314) 447-7500
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
145
AL
Other
Enumeration date
09/27/2006
Last updated
05/12/2023
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