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CH04038E NORTH FLORIDA MEDICAL CENTERS, INC. (Active)
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Main Details
Name
NORTH FLORIDA MEDICAL CENTERS, INC.
Subdivision Name
River Valley Medical Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008892
340B ID
CH04038E
Grant Number
H80CS00693
Additional Details
Current Program Status
Active
Registration Date
7/1/2000
Participating Start Date
7/1/2000
Participating Approval Date
2/25/2005
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
North Florida Medical Centers, Inc.
Tori Wiggins, CFO
(850) 298-6040
Primary Contact
North Florida Medical Centers, Inc.
Matthew R Mayo, Privacy Officer
(850) 298-6009
Addresses
Street Address
710 W Main St
Mayo, FL 32066-4127
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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1/24/12 - Changed AO and Contact name from DON PORTERFIELD. 1/12/12-Changed entity name to Mayo Medical Center from North Florida Medical Centers, Inc. 11/18/11 - Change main address from 144 SW VIRGINIA CIRCLE abd billing address from 535 John Knox road. 10/30/08 ADDED BILL TO
01/24/2012
11/18/11 - Change main address from 144 SW VIRGINIA CIRCLE abd billing address from 535 John Knox road. 10/30/08 ADDED BILL TO 1/12/12-Changed entity name to Mayo Medical Center from North Florida Medical Centers, Inc.
01/12/2012
11/18/11 - Change main address from 144 SW VIRGINIA CIRCLE abd billing address from 535 John Knox road. 10/30/08 ADDED BILL TO
11/18/2011
10/30/08 ADDED BILL TO
01/12/2010
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