Provider Demographics
NPI:1992108963
Name:GH LLC
Entity type:Organization
Organization Name:GH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSON GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-300-4022
Mailing Address - Street 1:6501 RED HOOK PLZ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-1373
Mailing Address - Country:US
Mailing Address - Phone:340-776-7342
Mailing Address - Fax:340-776-7349
Practice Address - Street 1:5302 YACHT HAVEN GRANDE
Practice Address - Street 2:SUITE S-100
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5004
Practice Address - Country:US
Practice Address - Phone:340-776-7342
Practice Address - Fax:340-776-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty