Provider Demographics
NPI:1952759730
Name:HOLMES REGIONAL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:HOLMES REGIONAL MEDICAL CENTER, INC.
Other - Org Name:HEALTH FIRST FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:ESROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-434-5197
Mailing Address - Street 1:1350 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:321-434-7488
Mailing Address - Fax:321-434-6105
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:321-434-7488
Practice Address - Fax:321-434-6105
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLMES REGIONAL MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-02
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH27937261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH27937OtherPHARMACY LICENSE