PUTNAM COMMUNITY MEDICAL CENTER LLC
Hospitals at Zeagler Dr, Palatka, FL

License number
Florida 4350
Category
Hospitals
Type
Rural
Owner
Name: DONALD J. BIVACCA
Title: PRESIDENT
Phone: (615) 920-7000
Address
Address 2
611 Zeagler Dr, Palatka, FL 32177
330 Seven Springs Way, Brentwood, TN 37027
National Provider ID: 1760599286
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PUTNAM COMMUNITY MEDICAL CENTER, LLC

Brentwood, TN

Status:
Inactive
Doing business as:
PUTNAM AMBULATORY SURGERY CENTER, LLC
Inactive reason:
LC WITHDRAWAL
Registration:
Apr 19, 2000
Inactive since:
May 1, 2015
Addresses:
330 7 Spg Way, Brentwood, TN 37027 (Physical)
103 Powell Ct, Brentwood, TN 37027
State ID:
M00000000770
Business type:
Foreign Limited Liability Company
Entity State:
DE
Manager, Managing Members:
Donald J. Bivacca, 330 7 Spg Way, Brentwood, TN 37027 (Physical),Steve W. Frantz (Manager, Treasurer), 330 7 Spg Way, Brentwood, TN 37027 (Physical),Bradley R Owens, 330 7 Spg Way, Brentwood, TN 37027 (Physical),...
Agent:
C T Corporation System,1200 S Pne Is Rd, Fort Lauderdale, FL 33324 (Physical)
EIN:
62-1818453

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