Basic Information
| Provider Information | |||||||||
| NPI: | 1528514676 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FRANKLIN COUNTY BOARD OF COUNTY COMMISSIONERS | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | GEORGE E. WEEMS MEMORIAL HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 135 AVENUE G | ||||||||
| Address2: | |||||||||
| City: | APALACHICOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323201613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8506538853 | ||||||||
| FaxNumber: | 8506531879 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 AVENUE G | ||||||||
| Address2: | |||||||||
| City: | APALACHICOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323201613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8506538853 | ||||||||
| FaxNumber: | 8506531879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2016 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | WALKER | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8506538853 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273Y00000X | N | Hospital Units | Rehabilitation Unit | 273Y00000X | FL | Y | Hospital Units | Rehabilitation Unit |
ID Information
| ID | Type | State | Issuer | Description | 005482800 | 05 | FL | MEDICAID |