Provider Demographics
NPI:1255941688
Name:HOLMES COUNTY HOSPITAL CORPORATION
Entity type:Organization
Organization Name:HOLMES COUNTY HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-547-8001
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-0188
Mailing Address - Country:US
Mailing Address - Phone:850-547-8158
Mailing Address - Fax:
Practice Address - Street 1:2910 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-4268
Practice Address - Country:US
Practice Address - Phone:850-547-8158
Practice Address - Fax:850-547-8090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLMES COUNTY HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-31
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty