Provider Demographics
NPI:1073517504
Name:HEALTH CARE DISTRICT OF PALM BEACH COUNTY
Entity Type:Organization
Organization Name:HEALTH CARE DISTRICT OF PALM BEACH COUNTY
Other - Org Name:HEALTH CARE DISTRICT -TRAUMA HAWK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-804-5885
Mailing Address - Street 1:1515 N FLAGLER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3429
Mailing Address - Country:US
Mailing Address - Phone:561-659-1270
Mailing Address - Fax:561-733-6663
Practice Address - Street 1:4255 SOUTHERN BLVD
Practice Address - Street 2:BLDG 1625-B, SUITE 307
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-1415
Practice Address - Country:US
Practice Address - Phone:561-659-1270
Practice Address - Fax:561-671-4669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL420003900Medicaid
FL420003900Medicaid