Provider Demographics
NPI:1588661581
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 HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:ABERCROMBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-973-2271
Mailing Address - Street 1:309 NE MARION STREET
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-2511
Mailing Address - Country:US
Mailing Address - Phone:850-973-6572
Mailing Address - Fax:850-973-8518
Practice Address - Street 1:309 NE MARION STREET
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2511
Practice Address - Country:US
Practice Address - Phone:850-973-6572
Practice Address - Fax:850-973-8518
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON COUNTY HOSPITAL HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-05
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21540096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-7481Medicare ID - Type Unspecified