Provider Demographics
NPI:1891792917
Name:MADISON COUNTY HOSPITAL HEALTH SYSTEMS INC
Entity type:Organization
Organization Name:MADISON COUNTY HOSPITAL HEALTH SYSTEMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HALFHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-973-1366
Mailing Address - Street 1:309 NE MARION ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-2511
Mailing Address - Country:US
Mailing Address - Phone:850-973-8851
Mailing Address - Fax:850-973-8158
Practice Address - Street 1:235 SW DADE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2363
Practice Address - Country:US
Practice Address - Phone:850-973-8851
Practice Address - Fax:850-973-8158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG04999021597261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL660093000Medicaid
FL660093000Medicaid