PANHANDLE RURAL HEALTH INCORPORATED NPI 1255398228

NPI Information

NPI: 1255398228
Provider Name: PANHANDLE RURAL HEALTH INCORPORATED

Doing Business As: JAY MEDICAL CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
14088 ALABAMA ST
JAY, FL
ZIP 32565
Phone: (850) 675-4546
Get Directions

PANHANDLE RURAL HEALTH INCORPORATED is a rural health clinic center in Jay, FL. PANHANDLE RURAL HEALTH INCORPORATED NPI is 1255398228. The provider is registered as an organization entity type.
The provider Is Doing Business As Jay Medical Clinic.

The provider's business location address is:

14088 ALABAMA ST
JAY, FL
ZIP 32565-036
Phone: (850) 675-4546
Fax: (850) 675-4548

The provider's authorized official is Cleatious David Smith .
The authorized official title is Owner Supervising Physician and has the following contact phone number (850) 675-4546.

The CLIA number assigned to this NPI record is 10D0884275 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 7/5/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	21333	OTHER	FLORIDA	BCBS OF FLORIDA GROUP NUMBER
2	660022100	MEDICAID	FLORIDA
3	103858	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA	CLINIC GROUP NUMBER
4	660022102	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »