Provider Demographics
NPI:1952114290
Name:NEIGHBORHOOD MEDICAL CENTER, INC
Entity type:Organization
Organization Name:NEIGHBORHOOD MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
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 1:438 W BREVARD ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-1004
Mailing Address - Country:US
Mailing Address - Phone:850-577-0045
Mailing Address - Fax:
Practice Address - Street 1:438 W BREVARD ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-1004
Practice Address - Country:US
Practice Address - Phone:850-577-0045
Practice Address - Fax:850-513-3277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD MEDICAL CENTER PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112812500Medicaid
FL112813300Medicaid
FL112813700Medicaid
FL112813600Medicaid
FL112813302Medicaid