Organization
BAKER COUNTY MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY VARNADOE (CHIEF EXECUTIVE OFFICER)
(904) 259-3151
Entity
Organization
Contact information
Practice address
159 N 3RD ST, MACCLENNY, FL 32063-2103
(904) 259-3151
(904) 259-3279
Mailing address
PO BOX 484, MACCLENNY, FL 32063-0484
(904) 259-3151
(904) 259-3279
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
4152
FL
314000000X
Skilled Nursing Facility
SNF1581096
FL
3336C0003X
Community/Retail Pharmacy
PH13709
FL
3336I0012X
Institutional Pharmacy
PH13710
FL
3336I0012X
Institutional Pharmacy
PH9039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010004800
—
FL
05
—
021105200
—
FL
05
—
022384100
—
FL
05
—
266702900
—
FL
Enumeration date
09/25/2006
Last updated
06/21/2021
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