| NPI | 1760657399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYIA KELLEY Provider Enrollment Specialist 904-244-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |