Provider Demographics
NPI:1194173419
Name:HOLMES COUNTY HOSPITAL CORPORATION
Entity type:Organization
Organization Name:HOLMES COUNTY HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-547-8001
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-0188
Mailing Address - Country:US
Mailing Address - Phone:850-547-8003
Mailing Address - Fax:850-547-8006
Practice Address - Street 1:5556 BROWN ST
Practice Address - Street 2:
Practice Address - City:GRACEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32440-1007
Practice Address - Country:US
Practice Address - Phone:850-360-4150
Practice Address - Fax:850-547-8006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLMES COUNTY HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-26
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health