| Madison Medical Center | |
|
235 Sw Dade St Suite A Madison FL 32340-2363 | |
| (850) 385-4494 | |
| Not Available |
| Full Name | Madison Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 235 Sw Dade St, Madison, Florida |
| Authorized Official Name and Position | Lane Miller Lunn (PRESIDENT/CEO) |
| Authorized Official Contact | 8503854494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Medical Center 2804 Remington Green Cir Ste 2 Tallahassee FL 32308-1550 Ph: (850) 385-4494 | Madison Medical Center 235 Sw Dade St Suite A Madison FL 32340-2363 Ph: (850) 385-4494 |
| NPI Number | 1144637109 |
|---|---|
| Provider Enumeration Date | 07/22/2014 |
| Last Update Date | 12/10/2020 |
| Medicare PECOS PAC ID | 6103737697 |
|---|---|
| Medicare Enrollment ID | O20141010000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144637109 | NPI | - | NPPES |
| 99388 | Other | FL | MEDICARE PARAT B, GROUP PTAN |
| 029568016 | Medicaid | FL | |
| 029568010 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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