Provider Demographics
NPI:1386082220
Name:BAKER COUNTY MEDICAL SERVICES INC
Entity type:Organization
Organization Name:BAKER COUNTY MEDICAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNADOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-259-3151
Mailing Address - Street 1:159 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2103
Mailing Address - Country:US
Mailing Address - Phone:904-259-3151
Mailing Address - Fax:904-259-3279
Practice Address - Street 1:159 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2103
Practice Address - Country:US
Practice Address - Phone:904-259-3151
Practice Address - Fax:904-259-3279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAKER COUNTY MEDICAL SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-13
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health