Provider Demographics
NPI:1558355057
Name:MUNROE REGIONAL HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:MUNROE REGIONAL HEALTH SYSTEMS INC
Other - Org Name:MIDWIVES OF OCALA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MUTARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-351-7327
Mailing Address - Street 1:324 SE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5362
Mailing Address - Country:US
Mailing Address - Phone:352-351-7327
Mailing Address - Fax:352-351-7336
Practice Address - Street 1:324 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5362
Practice Address - Country:US
Practice Address - Phone:352-351-7327
Practice Address - Fax:352-351-7336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MUNROE REGIONAL HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-12
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL034291200Medicaid
K1159Medicare UPIN
FLK1159Medicare ID - Type Unspecified