Healthcare Provider Details

I. General information

NPI: 1104821461
Provider Name (Legal Business Name): MADISON COUNTY HOSPITAL HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 NW CRANE AVE
MADISON FL
32340-1400
US

IV. Provider business mailing address

224 NW CRANE AVE
MADISON FL
32340-1400
US

V. Phone/Fax

Practice location:
  • Phone: 850-973-2271
  • Fax: 850-973-2818
Mailing address:
  • Phone: 850-973-2271
  • Fax: 850-973-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number4346
License Number StateFL

VIII. Authorized Official

Name: MRS. TAMMY STEVENS
Title or Position: C.E.O.
Credential:
Phone: 850-973-2271