Provider Demographics
NPI:1568934560
Name:POINT WASHINGTON MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:POINT WASHINGTON MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN
Authorized Official - Phone:850-213-1133
Mailing Address - Street 1:1321 N COUNTY HIGHWAY 395
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5916
Mailing Address - Country:US
Mailing Address - Phone:850-213-1133
Mailing Address - Fax:
Practice Address - Street 1:1321 N COUNTY HIGHWAY 395
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5916
Practice Address - Country:US
Practice Address - Phone:850-213-1133
Practice Address - Fax:850-213-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center