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103 U.s. Highway 27 Sw Branford FL 32008-3048 | |
(386) 935-3090 | |
(386) 935-3198 |
Full Name | |
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Speciality | Clinic/Center |
Location | 103 U.s. Highway 27 Sw, Branford, Florida |
Authorized Official Name and Position | Anita H. Rembert (CEO) |
Authorized Official Contact | 3864540698 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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23476 Nw 186th Ave High Springs FL 32643-0673 Ph: (386) 454-0698 | 103 U.s. Highway 27 Sw Branford FL 32008-3048 Ph: (386) 935-3090 |
NPI Number | 1508048596 |
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Provider Enumeration Date | 11/30/2007 |
Last Update Date | 01/10/2025 |
Medicare PECOS PAC ID | 2365359387 |
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Medicare Enrollment ID | O20080103000628 |
Identifier | Type | State | Issuer |
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1508048596 | NPI | - | NPPES |
029506007 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Three Rivers Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 208 Suwannee Ave Nw, Branford, FL 32008 Phone: 386-935-1607 Fax: 386-935-1667 | |