Organization
TALLAHASSEE MEMORIAL HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PARKS (PRESIDENT)
(850) 431-6234
Entity
Organization
Contact information
Practice address
15 COUNCIL MOORE RD, CRAWFORDVILLE, FL 32327-3117
(850) 926-7105
(850) 926-2034
Mailing address
1607 SAINT JAMES CT STE 1, TALLAHASSEE, FL 32308-5352
(850) 431-7021
(850) 431-6975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24766H
BCBS GROUP #
FL
05
—
375270406
—
FL
05
—
660037903
—
FL
Enumeration date
05/09/2006
Last updated
01/09/2025
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