Organization Name: | CAMPBELLTON-GRACEVILLE HOSPITAL |
NPI Number: | 1306143839 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIMMY B RIGSBY (ADMINISTRATOR) |
Mailing Address: | 5429 College Drive Suite B Graceville |
State: | FL US |
Postal Code: | 324401858 |
Phone Number: | 8502630639 |
Fax Number: | 8502639726 |
NPI Enumeration Date: | 02/18/2011 |
NPI Last Update Date: | 10/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |