Provider Demographics
NPI:1265831150
Name:HOLMES REGIONAL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:HOLMES REGIONAL MEDICAL CENTER, INC.
Other - Org Name:HEALTH FIRST FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:FELKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-434-5487
Mailing Address - Street 1:1350 SOUTH HICKORY STREET
Mailing Address - Street 2:HEALTH FIRST FAMILY PHARMACY
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3224
Mailing Address - Country:US
Mailing Address - Phone:321-434-7355
Mailing Address - Fax:321-434-6105
Practice Address - Street 1:1223 GATEWAY DR
Practice Address - Street 2:HEALTH FIRST FAMILY PHARMACY
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-434-7355
Practice Address - Fax:321-409-6861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
FLPH286123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy