| Name: | Gulf Coast Surgical Partners, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Oct 2001 (23 years ago) |
| Entity Number: | 000-678-392 |
| Register Number: | 000678392 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 1000-A CODY ROAD SMOBILE, AL 36695 |
| Registered Office Street Address ZIP Code: | 36695 |
Activities
OWN/OPERATE/MANAGE OUTPATIENT SURGERY FACILITIES/EQUIPMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740288679 | 2005-07-13 | 2019-11-14 | 4721 MORRISON DR STE 400, MOBILE, AL, 366093350, US | 3610 SPRINGHILL MEMORIAL DR N, MOBILE, AL, 366081162, US | |||||||||||||||||||||||||||
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| Phone | +1 251-272-4934 |
| Fax | 2514605457 |
| Phone | +1 251-410-3800 |
Authorized person
| Name | MARY MCGUIRE |
| Role | FINANCIAL DIRECTOR |
| Phone | 2514605280 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 5989 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | ASC0071C |
| State | AL |
| Name | Role | Address |
|---|---|---|
| HALL, CHARLES E | Member | No data |
| SPRINGHILL MEDICAL COMPLEX INC | Member | No data |
| SUCHER, RANDY A | Member | No data |
| ST CLAIR, JEFFREY M | Member | No data |
| CROTWELL, WILLIAM A | Member | No data |
| DEMPSEY, THOMAS R | Member | 152 COLLEGE LANEMOBILE, AL 36608 |
| FONTANA, ANDRE J | Member | No data |
| GRANBERRY, MICHAEL J | Member | No data |
| ZARZOUR, ROBERT J | Member | No data |
| MASON, L DEAN II | Member | 1711 NORTH MCKENZIE STREETFOLEY, AL 36536 |
| Name | Role |
|---|---|
| TIMOTHY W KAUFMAN | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
