MEDICARE: HOLMES COUNTY HOSPITAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC0060X	Critical Access Hospital
2	282NC0060X	Critical Access Hospital	4427	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CH0342	OTHER		MEDICARE RAIL ROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	428	OTHER	FL	BC/BS PROVIDER NUMBER

General Provider Information

NPI Number	:	1366431702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLMES COUNTY HOSPITAL CORP

Provider Business Mailing Address
First Line	:	P.O. BOX 188
Second Line	:
City	:	BONIFAY
State	:	FL
Zip	:	32425
Country	:	US
Telephone Number	:	850-547-8015
Fax Number	:	850-547-8025

Provider Business Practice Location Address
First Line	:	2600 HOSPITAL DRIVE
Second Line	:
City	:	BONIFAY
State	:	FL
Zip	:	32425
Country	:	US
Telephone Number	:	850-547-8015
Fax Number	:	850-547-8025

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	MRS. JOANN BAKER
Credential	:
Telephone Number	:	850-547-8001

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	03/31/2022

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Directions to “HOLMES COUNTY HOSPITAL CORP ” Practice Location

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