Provider Demographics
NPI:1841043379
Name:NEIGHBORHOOD MEDICAL CENTER, INC
Entity type:Organization
Organization Name:NEIGHBORHOOD MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-577-1558
Mailing Address - Street 1:2613 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-6308
Mailing Address - Country:US
Mailing Address - Phone:850-759-0347
Mailing Address - Fax:
Practice Address - Street 1:2613 S MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6308
Practice Address - Country:US
Practice Address - Phone:850-759-0347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112913600Medicaid
FL112813700Medicaid
FL112812500Medicaid
FL112813300Medicaid
FL112813302Medicaid
FL333600000XOtherPHARMACY