1740676220 NPI number — PUTNAM COMMUNITY MEDICAL CENTER OF NORTH FLORIDA, LLC

Table of content: (NPI 1740676220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740676220 NPI number — PUTNAM COMMUNITY MEDICAL CENTER OF NORTH FLORIDA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUTNAM COMMUNITY MEDICAL CENTER OF NORTH FLORIDA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HCA FLORIDA PUTNAM HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740676220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 PARK PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-6527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-344-9551
Provider Business Mailing Address Fax Number:
615-344-1600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 ZEAGLER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALATKA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32177-3810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-328-5711
Provider Business Practice Location Address Fax Number:
386-325-8178
Provider Enumeration Date:
04/10/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PARK
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
386-326-8002

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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