National Provider Identifier Database

BAKER COUNTY MEDICAL SERVICES INC
Rural


Contact Information

BAKER COUNTY MEDICAL SERVICES INC
159 N 3RD ST
MACCLENNY, FL32063-2103
Phone: 904-259-3151
Fax: 904-259-3279
Website:
Specialty Taxonomy Code
* Rural 282NR1301X
Community/Retail Pharmacy 3336C0003X
Institutional Pharmacy 3336I0012X
Skilled Nursing Facility 314000000X

* Indicates primary specialty

NPI Profile & details for BAKER COUNTY MEDICAL SERVICES INC

NPI Number 1104926401
Legal business name
LBN
BAKER COUNTY MEDICAL SERVICES INC
Authorized official TIFFANY VARNADOE - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 09/25/2006
Last updated 06/21/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: 4152
  • FL License #: PH13709
  • FL License #: PH13710
  • FL License #: PH9039
  • FL License #: SNF1581096
  • FL Medicaid: 010004800
  • FL Medicaid: 021105200
  • FL Medicaid: 022384100
  • FL Medicaid: 266702900

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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