Wakulla Medical Center | |
1328 Coastal Hwy Panacea FL 32346-2151 | |
(850) 984-4735 | |
(850) 984-4742 |
Full Name | Wakulla Medical Center |
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Speciality | Clinic/Center |
Location | 1328 Coastal Hwy, Panacea, 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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Wakulla Medical Center 2804 Remington Green Cir Ste 2 Tallahassee FL 32308-1550 Ph: (850) 385-4494 | Wakulla Medical Center 1328 Coastal Hwy Panacea FL 32346-2151 Ph: (850) 984-4735 |
NPI Number | 1447254958 |
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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 | O20100827000938 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447254958 | NPI | - | NPPES |
029568001 | Medicaid | FL | |
029568021 | Medicaid | FL | |
99388 | Other | FL | MEDICARE PART B, GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 00000 (Florida) | Primary |