Live Oak Hma LLC

Organization Active NPI Rural Health Clinic/Center · Jasper, FL

NPI 1922409010 · NPPES record last updated Oct 16, 2019

Key facts

NPI
1922409010
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
4314 (FL)
Legal business name
LIVE OAK HMA LLC
Practice address
413 5TH Ave NW Ste a
Jasper, FL 32052-7801
Phone
(386) 292-8132
Fax
(386) 792-7745
NPI assigned
Sep 9, 2014
Organization subpart
No

Authorized official

Name
Paula Lalor
Title
Director/Delegated Official
Phone
(615) 925-4565

National Provider Directory

Locations

1150 US Highway 41 NW
Ste 11
Jasper, FL 32052
Phone (386) 292-6563

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 4314 FL Yes

Addresses

Primary practice location

413 5TH Ave NW Ste a
Jasper, FL 32052-7801

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 778-8196

Other identifiers

IdentifierTypeStateIssuer
016770200MedicaidFL

Other names

  • Hamilton Primary Care Doing business as

Other providers in Jasper, FL

All providers in Jasper, FL · Rural Health Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.