Provider Demographics
NPI:1255364477
Name:GULF COAST VAMC
Entity type:Organization
Organization Name:GULF COAST VAMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADDICTION THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:FINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:228-523-4773
Mailing Address - Street 1:2231 POPPS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-4114
Mailing Address - Country:US
Mailing Address - Phone:228-424-8361
Mailing Address - Fax:
Practice Address - Street 1:400 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2410
Practice Address - Country:US
Practice Address - Phone:228-523-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital