Organization Name: | BAYLINE MEDICAL CENTER INC |
NPI Number: | 1922038694 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM DANA HOLTON (OWNER CEO) |
Mailing Address: | 402 Hwy 98 East Carrabelle |
State: | FL US |
Postal Code: | 323221078 |
Phone Number: | 8506975540 |
Fax Number: | 8506972477 |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |