Provider Demographics
NPI:1780814152
Name:GULF COAST HEALTHCARE GROUP
Entity type:Organization
Organization Name:GULF COAST HEALTHCARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KWESI
Authorized Official - Middle Name:A
Authorized Official - Last Name:DARQUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-245-0980
Mailing Address - Street 1:301 W KIRBY ST
Mailing Address - Street 2:SUITE 233
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4194
Mailing Address - Country:US
Mailing Address - Phone:469-254-0980
Mailing Address - Fax:972-429-9233
Practice Address - Street 1:12989 JUPITER RD
Practice Address - Street 2:SUITE 104
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-3212
Practice Address - Country:US
Practice Address - Phone:469-254-0980
Practice Address - Fax:972-429-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health