Search icon

Gulf Coast Surgical Partners, LLC

Details

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

National Provider Identifier

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

Contacts

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

Member

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

Agent

Name Role
TIMOTHY W KAUFMAN Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State