Provider Demographics
NPI:1447827431
Name:MERCY MEDICAL HEALTH CENTER OF GULF SHORES
Entity type:Organization
Organization Name:MERCY MEDICAL HEALTH CENTER OF GULF SHORES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-259-1100
Mailing Address - Street 1:3849 GULF SHORES PKWY STE 9
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-2857
Mailing Address - Country:US
Mailing Address - Phone:251-957-8970
Mailing Address - Fax:251-957-8971
Practice Address - Street 1:3849 GULF SHORES PKWY STE 9
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-2857
Practice Address - Country:US
Practice Address - Phone:318-259-1100
Practice Address - Fax:318-259-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL296466Medicaid