| Entity Name: | HOLMES COUNTY HOSPITAL CORPORATION |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 27 Apr 1992 (33 years ago) |
| Document Number: | N48565 |
| FEI/EIN Number | 596031176 |
| Address: | 2600 HOSPITAL DRIVE, BONIFAY, FL, 32425 |
| Mail Address: | PO BOX 188, BONIFAY, FL, 32425 |
| ZIP code: | 32425 |
| County: | Holmes |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548856693 | 2020-12-14 | 2020-12-14 | 2600 HOSPITAL DR, BONIFAY, FL, 324254264, US | 1424 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324353401, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 850-547-8029 |
| Fax | 8505478025 |
| Phone | +1 850-547-8118 |
Authorized person
| Name | TRACEY LONG |
| Role | ADMINISTRATIVE ASSISTANT |
| Phone | 8505478003 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BAKER JOANN | Agent | 2600 HOSPITAL DRIVE, BONIFAY, FL, 32425 |
| Name | Role | Address |
|---|---|---|
| Goodman Jennie | Vice President | 1510 Jenkins Road, BONIFAY, FL, 32425 |
| Name | Role | Address |
|---|---|---|
| Dixon Jerry Sr. | Boar | 3754 Highway 2, Bonifay, FL, 32425 |
| Brooks Cynthia | Boar | 2126 Highway 173, Bonifay, FL, 32425 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000075817 | DOCTORS MEMORIAL HOSPITAL | ACTIVE | 2022-06-23 | 2027-12-31 | No data | 2600 HOSPITAL DRIVE, BONIFAY, FL, 32425 |
| G20000157472 | DEFUNIAK SPRINGS HEALTH CLINIC | ACTIVE | 2020-12-11 | 2025-12-31 | No data | P.O. BOX 188, BONIFAY, FL, 32425 |
| G20000128404 | DOCTORS MEMORIAL HEALTH CLINIC | ACTIVE | 2020-10-02 | 2025-12-31 | No data | P.O. BOX 188, BONIFAY, FL, 32425 |
| G20000120162 | BONIFAY RURAL HEALTH CLINIC | ACTIVE | 2020-09-15 | 2025-12-31 | No data | 2910 HOSPITAL DRIVE, P.O. BOX 188, BONIFAY, FL, 32425 |
| G16000092495 | DOCTORS MEDICAL CLINIC | EXPIRED | 2016-08-25 | 2021-12-31 | No data | P.O. BOX 188, 2910 HOSPITAL DRIVE, BONIFAY, FL, 32425 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2004-11-30 | No data | No data |
| EVENT CONVERTED TO NOTES | 1992-04-27 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
