Healthcare Provider Details

I. General information

NPI: 1366431702
Provider Name (Legal Business Name): HOLMES COUNTY HOSPITAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 HOSPITAL DRIVE
BONIFAY FL
32425
US

IV. Provider business mailing address

P.O. BOX 188
BONIFAY FL
32425
US

V. Phone/Fax

Practice location:
  • Phone: 850-547-8015
  • Fax: 850-547-8025
Mailing address:
  • Phone: 850-547-8015
  • Fax: 850-547-8025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number4427
License Number StateFL

VIII. Authorized Official

Name: MRS. JOANN BAKER
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 850-547-8001