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NPI Code Detail

MEDICARE: BIG BEND OPERATIONS

MEDICARE: BIG BEND OPERATIONS
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
1156FX1800XOptician
2261QA1903XAmbulatory Surgical Clinic/Center1076FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699770545
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIG BEND OPERATIONS
Provider Business Mailing Address
First Line : 555 N BYRON BUTLER PKWY
Second Line :
City : PERRY
State : FL
Zip : 32347-2315
Country : US
Telephone Number : 850-584-2778
Fax Number : 850-584-2790
Provider Business Practice Location Address
First Line : 555 N BYRON BUTLER PKWY
Second Line :
City : PERRY
State : FL
Zip : 32347-2315
Country : US
Telephone Number : 850-584-2778
Fax Number : 850-584-2790
Authorized Official
Title or Position : MANAGER EMPLOYEE / CEO
Name : CHARLES SCOTT KEELER
Credential :
Telephone Number : 850-584-2778
Provider Enumeration Date : 06/16/2005
Last Update Date : 02/19/2009

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Directions to “BIG BEND OPERATIONS ” Practice Location

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