Healthcare Provider Details

I. General information

NPI: 1255941688
Provider Name (Legal Business Name): HOLMES COUNTY HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 HOSPITAL DR STE B
BONIFAY FL
32425-4268
US

IV. Provider business mailing address

PO BOX 188
BONIFAY FL
32425-0188
US

V. Phone/Fax

Practice location:
  • Phone: 850-547-8158
  • Fax: 850-547-8090
Mailing address:
  • Phone: 850-547-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOANN BAKER
Title or Position: ADMINISTRATOR
Credential:
Phone: 850-547-8001