1891732988 NPI number — OKALOOSA HOSPITAL INC

Table of content: (NPI 1891732988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891732988 NPI number — OKALOOSA HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OKALOOSA HOSPITAL INC
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 TWIN CITIES 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:
1891732988
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2190 HIGHWAY 85 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NICEVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32578-1045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-678-4131
Provider Business Mailing Address Fax Number:
850-729-9306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2190 HIGHWAY 85 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NICEVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32578-1045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-678-4131
Provider Business Practice Location Address Fax Number:
850-729-9306
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DAY
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
850-729-9300

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000349808X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 071778701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10125700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112638 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 02212833 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 216064 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: TWI0054N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200248350A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 288 . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 508490 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010125700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com