TRENTON MEDICAL CENTER, INC (NPI# 1972140358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972140358 |
Entity Type | Organization |
Organization Name | TRENTON MEDICAL CENTER, INC |
Other Organization Name | PALMS MEDICAL GROUP |
Practice Address |
4784 W Us Highway 90 Lake City FL 32055-3101 |
Mailing Address |
23343 Nw County Road 236 High Springs FL 32643-9669 |
Practice Telephone | 3862699260 |
Practice Fax Number | 3864066714 |
Mailing Telephone | 3864540698 |
Mailing Fax Number | 3864540690 |
Enumeration Date | 2019-12-05 |
Last Update Date | 2019-12-30 |
Authorized Official Name | ANITA H. RIELS (CEO) |
Authorized Official Telephone | 3864540698 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Palms Medical Group | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912213000 | Trenton Medical Center, Inc | Clinic/Center | 550 W. Georgia St, Starke, FL 32091-1816 | 2010-08-26 |
1639363591 | Trenton Medical Center, Inc | Pharmacy | 911 S Main St, Trenton, FL 32693-3239 | 2007-09-04 |
1861694531 | Trenton Medical Center, Inc | Pharmacy | 1830 N Main St, Bell, FL 32619-4713 | 2007-06-04 |
1164642419 | Trenton Medical Center, Inc | Clinic/Center | 1830 N Main St, Bell, FL 32619-4713 | 2007-04-27 |
1700801396 | Trenton Medical Center, Inc | Pharmacy | 1830 N Main St, Bell, FL 32619-4713 | 2006-07-13 |
Street Address |
4784 W US HIGHWAY 90 |
City | LAKE CITY |
State | FL |
Zip Code | 32055-3101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467814582 | Osayamen O Omoruyi | Family Medicine | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2016-03-28 |
1124627930 | Beth Harris Henderson | Nurse Practitioner | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2020-10-22 |
1679122337 | Trenton Medical Center, Inc. | Pharmacy | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2019-09-05 |
1811436751 | Jana Ruth Underhill | Nurse Practitioner | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2017-02-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
Find all providers in zip 32055 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1801081294 | Arcare | Clinic/Center | 1009 Highway 18, Lake City, AR 72437-9622 | 2007-09-10 |
1114353786 | Hopehealth, Inc | Clinic/Center | 652 N Matthews Rd, Lake City, SC 29560-7008 | 2013-09-16 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.