Provider Demographics
NPI:1013336908
Name:VILLAGES TRI-COUNTY MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:VILLAGES TRI-COUNTY MEDICAL CENTER INC.
Other - Org Name:THE VILLAGES REGIONAL HOSPITAL EAST CAMPUS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-323-5762
Mailing Address - Street 1:1501 N US HIGHWAY 441
Mailing Address - Street 2:SUITE 1830
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8999
Mailing Address - Country:US
Mailing Address - Phone:352-751-8828
Mailing Address - Fax:
Practice Address - Street 1:1501 N US HIGHWAY 441
Practice Address - Street 2:SUITE 1830
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8999
Practice Address - Country:US
Practice Address - Phone:352-751-8828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center