Provider Demographics
NPI:1295987691
Name:JAMES E HOLMES REGIONAL HOSPITAL
Entity type:Organization
Organization Name:JAMES E HOLMES REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-315-3569
Mailing Address - Street 1:1350 S HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3224
Mailing Address - Country:US
Mailing Address - Phone:321-434-7355
Mailing Address - Fax:321-434-7343
Practice Address - Street 1:1350 HICKORY ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3224
Practice Address - Country:US
Practice Address - Phone:321-434-7355
Practice Address - Fax:321-434-7343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH FIRST INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-16
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH22857282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital