Provider Demographics
NPI:1740276518
Name:VILLAGES TRI-COUNTY MEDICAL CENTER INC.
Entity type:Organization
Organization Name:VILLAGES TRI-COUNTY MEDICAL CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-323-5001
Mailing Address - Street 1:1451 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-0041
Mailing Address - Country:US
Mailing Address - Phone:352-751-8946
Mailing Address - Fax:352-751-8945
Practice Address - Street 1:1451 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-0041
Practice Address - Country:US
Practice Address - Phone:352-751-8946
Practice Address - Fax:352-751-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010317900Medicaid
FL588OtherBLUE CROSS ID #
FL588OtherBLUE CROSS ID #