Provider Demographics
NPI:1831233360
Name:ORTHODOX CATHOLIC HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:ORTHODOX CATHOLIC HEALTHCARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-673-8338
Mailing Address - Street 1:235 SW DADE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-2361
Mailing Address - Country:US
Mailing Address - Phone:850-673-8338
Mailing Address - Fax:850-948-2822
Practice Address - Street 1:235 SW DADE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2361
Practice Address - Country:US
Practice Address - Phone:850-673-8338
Practice Address - Fax:850-948-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2180111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22005OtherBLUECROSS BLUESHIELD