| Tallahassee Memorial Healthcare Inc | |
|
1549 S Jefferson St Monticello FL 32344-1651 | |
| (850) 997-0707 | |
| (850) 997-6833 |
| Full Name | Tallahassee Memorial Healthcare Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1549 S Jefferson St, Monticello, Florida |
| Authorized Official Name and Position | Robin L Moss (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8504316256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tallahassee Memorial Healthcare Inc 1607 Saint James Ct Ste 1 Tallahassee FL 32308-5352 Ph: (850) 431-7021 | Tallahassee Memorial Healthcare Inc 1549 S Jefferson St Monticello FL 32344-1651 Ph: (850) 997-0707 |
| NPI Number | 1649229402 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 01/28/2019 |
| Medicare PECOS PAC ID | 6103724778 |
|---|---|
| Medicare Enrollment ID | O20100315000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649229402 | NPI | - | NPPES |
| 660037901 | Medicaid | FL | |
| 24766E | Other | FL | BCBS GROUP NUMBER |
| 375270408 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Florida) | Primary |
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Tallahassee Memorial Healthcare Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1549 S Jefferson St, Monticello, FL 32344 Phone: 850-997-0707 |