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Provider Information for 1750659447


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MOBILE INFIRMARY ASSOCIATION

Other Names:  
Doing Business As: 
MIMC RX4U
Former Legal Business Name: 
GULF HEALTH MANAGEMENT SERVICES, INC.

Organization Subpart: NO

NPI: 1750659447
Last Updated: 2023-11-21
Certification Date: 2023-11-21

Details

NameValue
NPI1750659447
Enumeration Date2011-12-08
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: DOUGLAS MARK NIX
Title: President/CEO
Phone: 2514357948
Mailing Address PO BOX 1468
DAPHNE, AL 36526-1468
United States

Phone: 251-435-7948 | Fax:251-435-6514
 
Primary Practice Address 1 MOBILE INFIRMARY CIR
MOBILE, AL 36607-3522
United States

Phone: 251-435-7948 | Fax:251-435-6514
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDAL166519
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyAL113835