Organization
NORTHWEST FLORIDA HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG J MOREAU (CFO & COO)
(850) 415-8197
Entity
Organization
Contact information
Practice address
1360 BRICKYARD RD, CHIPLEY, FL 32428-6303
(850) 638-1610
(850) 638-5764
Mailing address
1360 BRICKYARD RD, CHIPLEY, FL 32428-6303
(850) 638-1610
(850) 638-5764
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
4005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
594
BLUE CROSS SWING
FL
05
—
NONE
—
FL
Enumeration date
01/02/2007
Last updated
08/22/2020
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