NPIMap

Organization Active NPI

Baker County Medical Services, Inc

Doing business as Ed Fraser Memorial Hospital

  • Community/Retail Pharmacy
  • Macclenny, FL
National Provider Identifier
1093468688
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BAKER COUNTY MEDICAL SERVICES, INC
Doing business as
Ed Fraser Memorial Hospital
Practice address
159 N 3Rd St
Macclenny, FL 32063-2103
Phone
(904) 259-3151
Fax
(904) 653-4669
NPI assigned
Feb 2, 2022
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BAKER COUNTY MEDICAL SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tiffany Varnadoe
Title
Ceo
Phone
(706) 437-2683

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

159 N 3Rd St
Macclenny, FL 32063-2103

Mailing address

159 N 3Rd St
Macclenny, FL 32063-2103
Phone (904) 259-3151

Other names 1

  • Ed Fraser Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baker County Med SVCS Inc5 organizations share this tax ID, including this one
Part of
Baker County Med SVCS Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1093468688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 N 3RD ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632103",
            "telephone_number": "904-259-3151",
            "fax_number": "904-653-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 N 3RD ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632103",
            "telephone_number": "904-259-3151",
            "fax_number": "904-653-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKER COUNTY MEDICAL SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAKER COUNTY MEDICAL SERVICES INC",
        "enumeration_date": "2022-02-02",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "VARNADOE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-437-2683"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ed Fraser Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ed Fraser Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macclenny, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.