Organization Active NPI

Gulf Coast Vascular Labs LLC

  • Ambulatory Surgical Clinic/Center
  • Mobile, AL
National Provider Identifier
1164379632
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GULF COAST VASCULAR LABS LLC
Practice address
1551 Old Shell Rd
Mobile, AL 36604-1354
Phone
(251) 433-1180
NPI assigned
Mar 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gregg Miller, MDNPI 1942273560
Title
Authorized Official
Phone
(717) 515-4048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1551 Old Shell Rd
Mobile, AL 36604-1354

Mailing address

200 N Warner Rd Ste 205
King of Prussia, PA 19406-2841
Phone (610) 644-8900

Other practice location 1

336 North Broad St., Suite A
Mobile, AL 36603-0000
Phone (251) 433-1180

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1164379632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N WARNER RD STE 205",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062841",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 OLD SHELL RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041354",
            "telephone_number": "251-433-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 North Broad St., Suite A",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366030000",
            "country_code": "US",
            "telephone_number": "251-433-1180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GULF COAST VASCULAR LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "717-515-4048",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.