# BAKER COUNTY MEDICAL SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104926401
- **Authorized official:** MRS. TIFFANY VARNADOE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (904) 259-3151

## Contact information

- **Practice address:** 159 N 3RD ST, MACCLENNY, FL 32063-2103
- **Practice address phone:** (904) 259-3151
- **Practice address fax:** (904) 259-3279
- **Mailing address:** PO BOX 484, MACCLENNY, FL 32063-0484
- **Mailing address phone:** (904) 259-3151
- **Mailing address fax:** (904) 259-3279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | 4152 | FL | Yes |
| 314000000X | Skilled Nursing Facility | SNF1581096 | FL | — |
| 3336C0003X | Community/Retail Pharmacy | PH13709 | FL | — |
| 3336I0012X | Institutional Pharmacy | PH13710 | FL | — |
| 3336I0012X | Institutional Pharmacy | PH9039 | FL | — |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 06/21/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 010004800 | — | FL |
| 05 | — | 021105200 | — | FL |
| 05 | — | 022384100 | — | FL |
| 05 | — | 266702900 | — | FL |