Provider Demographics
NPI:1477567469
Name:PATIENTS FIRST NORTH MEDICAL CENTER PA
Entity Type:Organization
Organization Name:PATIENTS FIRST NORTH MEDICAL CENTER PA
Other - Org Name:PATIENTS FIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:E
Authorized Official - Last Name:EASTERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-562-2010
Mailing Address - Street 1:3258 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2822
Mailing Address - Country:US
Mailing Address - Phone:850-562-2010
Mailing Address - Fax:850-562-8899
Practice Address - Street 1:3258 N MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-2822
Practice Address - Country:US
Practice Address - Phone:850-562-2010
Practice Address - Fax:850-562-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253458400Medicaid
FL253458400Medicaid
FL77965Medicare PIN