Healthcare Provider Details

I. General information

NPI: 1114188927
Provider Name (Legal Business Name): MEDLINK MANAGEMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 SE 3RD AVE
LAKE BUTLER FL
32054-2647
US

IV. Provider business mailing address

PO BOX 748
LAKE BUTLER FL
32054-0748
US

V. Phone/Fax

Practice location:
  • Phone: 386-496-1922
  • Fax: 386-496-4777
Mailing address:
  • Phone: 386-496-1922
  • Fax: 386-496-4777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number800012290
License Number StateFL

VIII. Authorized Official

Name: MRS. PAULA GAY WEBB
Title or Position: PRESIDENT & CEO
Credential:
Phone: 386-496-2323