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CH04038Z NORTH FLORIDA MEDICAL CENTERS, INC. (Terminated)
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Main Details
Name
NORTH FLORIDA MEDICAL CENTERS, INC.
Subdivision Name
Baker Family Medical Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008103
340B ID
CH04038Z
Grant Number
H80CS00693
Additional Details
Current Program Status
Terminated
Registration Date
2/26/2009
Participating Start Date
4/1/2009
Participating Approval Date
2/24/2009
Last Recertification Date
2/13/2017
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
North Florida Medical Centers, Inc.
Tori Wiggins, CFO
(850) 298-6040
Primary Contact
North Florida Medical Centers,Inc
Lane Lunn, Chief Executive Officer
(850) 298-6001
Addresses
Street Address
1321 Georgia Ave
Baker, FL 32531-2605
Billing Address
NORTH FLORIDA MEDICAL CENTERS INC.
2804 Remington Green Circle
TALLAHASSEE, FL 32308-8707
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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