| Hampton Court | |
|
301 S 10th St Haines City FL 33844-5601 | |
| (863) 421-2982 | |
| Not Available |
| Full Name | Hampton Court |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 301 S 10th St, Haines City, Florida |
| Authorized Official Name and Position | Jas Lally (VICE PRESIDENT) |
| Authorized Official Contact | 8634212982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hampton Court 301 S 10th St Haines City FL 33844-5601 Ph: (863) 421-2982 | Hampton Court 301 S 10th St Haines City FL 33844-5601 Ph: (863) 421-2982 |
| NPI Number | 1487821807 |
|---|---|
| Provider Enumeration Date | 05/14/2008 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487821807 | NPI | - | NPPES |
| 11194301 | Other | FL | MEDICAID DIVERSION PROVIDER # |
| 284871 | Other | FL | DIVERSION PROVIDER # |
| 6000793 | Other | FL | MEDICAID DIVERSION PROVIDER # |
| 683660700 | Medicaid | FL | |
| 140884400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | AL9965 (Florida) | Primary |
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