# MEMORIAL HEALTH SYSTEMS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AdventHealth Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275640997
- **Authorized official:** CORY DOMAYER (VP)
- **Authorized official phone:** (383) 231-3906

## Contact information

- **Practice address:** 61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164-5999
- **Practice address phone:** (386) 671-4519
- **Mailing address:** PO BOX 730729, ORMOND BEACH, FL 32173-0729
- **Mailing address phone:** (386) 671-4500
- **Mailing address fax:** (386) 672-9904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 02/26/2021