Organization
CAMPBELLTON-GRACEVILLE HOSPITAL
Active
Parent organization
CAMPBELLTON-GRACEVILLE HOSPITAL
Other names
Graceville Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAMPBELLTON-GRACEVILLE HOSPITAL
Authorized official
MS. DENA R COOPER (CONTROLLER)
(850) 263-4431
Entity
Organization
Contact information
Practice address
5429 COLLEGE DR, GRACEVILLE, FL 32440-1857
(850) 263-4431
(850) 263-3312
Mailing address
5470 COLLEGE DR, GRACEVILLE, FL 32440-1304
(850) 263-2459
(850) 263-3312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME90551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060622701
—
FL
Enumeration date
02/01/2007
Last updated
07/14/2008
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