| Organization Name: | TRENTON MEDICAL CENTER, INC. |
| NPI Number: | 1124432042 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANITA H RIELS (C.E.O.) |
| Mailing Address: | 915 Nobles Ferry Rd Live Oak |
| State: | FL US |
| Postal Code: | 320648463 |
| Phone Number: | 3863641751 |
| Fax Number: | 3863641761 |
| NPI Enumeration Date: | 06/18/2014 |
| NPI Last Update Date: | 06/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |