Provider Demographics
NPI:1083684856
Name:MADISON COUNTY HOSPITAL HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:MADISON COUNTY HOSPITAL HEALTH SYSTEMS, INC.
Other - Org Name:MADISON COUNTY MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-973-2271
Mailing Address - Street 1:224 NW CRANE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-1400
Mailing Address - Country:US
Mailing Address - Phone:850-973-2271
Mailing Address - Fax:850-973-2818
Practice Address - Street 1:224 NW CRANE AVENUE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-1400
Practice Address - Country:US
Practice Address - Phone:850-973-2271
Practice Address - Fax:850-973-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4346275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020053100Medicaid
10Z311Medicare Oscar/Certification
FL10-Z311Medicare Oscar/Certification