Provider Demographics
NPI:1538590682
Name:GULF COAST HEALTH EDUCATORS
Entity type:Organization
Organization Name:GULF COAST HEALTH EDUCATORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEOBRAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLBYF
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDE
Authorized Official - Phone:228-234-2046
Mailing Address - Street 1:212 E SECOND ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-4458
Mailing Address - Country:US
Mailing Address - Phone:228-860-7530
Mailing Address - Fax:888-784-6667
Practice Address - Street 1:212 E SECOND ST
Practice Address - Street 2:SUITE A
Practice Address - City:PASS CHRISTIAN
Practice Address - State:MS
Practice Address - Zip Code:39571-4458
Practice Address - Country:US
Practice Address - Phone:228-860-7530
Practice Address - Fax:888-784-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty