Provider Demographics
NPI:1851939334
Name:CYPRESS MEDICAL CARE SERVICES
Entity Type:Organization
Organization Name:CYPRESS MEDICAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:850-247-0555
Mailing Address - Street 1:154 GLADSTONE RD
Mailing Address - Street 2:
Mailing Address - City:WEWAHITCHKA
Mailing Address - State:FL
Mailing Address - Zip Code:32465-5206
Mailing Address - Country:US
Mailing Address - Phone:850-247-0555
Mailing Address - Fax:
Practice Address - Street 1:4294 3RD AVE
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2137
Practice Address - Country:US
Practice Address - Phone:850-526-3191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty