River Valley Medical Center | |
710 W Main St Mayo FL 32066-4127 | |
(386) 294-1446 | |
(386) 294-4218 |
Full Name | River Valley Medical Center |
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Speciality | Clinic/Center |
Location | 710 W Main St, Mayo, 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 |
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River Valley Medical Center 2804 Remington Green Cir Ste 2 Tallahassee FL 32308-1550 Ph: (850) 385-4494 | River Valley Medical Center 710 W Main St Mayo FL 32066-4127 Ph: (386) 294-1446 |
NPI Number | 1235133745 |
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Provider Enumeration Date | 06/13/2005 |
Last Update Date | 12/10/2020 |
Medicare PECOS PAC ID | 6103737697 |
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Medicare Enrollment ID | O20100827000950 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235133745 | NPI | - | NPPES |
029568009 | Medicaid | FL | |
029568029 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 00000 (Florida) | Primary |
Dmh Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 E Main St, Mayo, FL 32066 Phone: 386-294-2475 Fax: 386-294-2478 |