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General NPI Number Information
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NPI Number | 1811953128
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Entity Type | Organization
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Legal Business Name | TALLAHASSEE MEMORIAL HEALTHCARE INC.
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 178 LASALLE LEFALL DR
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City | QUINCY
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State | FL
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Zip | 32351-5278
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Country | US
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Telephone | 850-875-3600
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Fax | 850-627-7277
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Provider Business Mailing Address
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Address Line | 1607 SAINT JAMES CT STE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5352
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Country | US
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Telephone | 850-431-7021
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Fax | 850-431-6975
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBIN L MOSS
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Credential |
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Telephone | 850-431-7021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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