Provider Demographics
NPI:1598758815
Name:MEDICAL SERVICES OF NORTHWEST FL
Entity Type:Organization
Organization Name:MEDICAL SERVICES OF NORTHWEST FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:KILBOURN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-936-0400
Mailing Address - Street 1:8974 NAVARRE PKWY
Mailing Address - Street 2:MEDICAL SERVICES OF NORTHWEST FLORIDA INC
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-2157
Mailing Address - Country:US
Mailing Address - Phone:850-936-0400
Mailing Address - Fax:850-936-0450
Practice Address - Street 1:8974 NAVARRE PKWY
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2157
Practice Address - Country:US
Practice Address - Phone:850-936-0400
Practice Address - Fax:850-936-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20707096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health