# QHG OF JACKSONVILLE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** QHG OF JACKSONVILLE INC
- **Other names:** Jacksonville Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1457458820
- **Legal business name:** QHG OF JACKSONVILLE INC
- **Authorized official:** DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (877) 892-9813

## Contact information

- **Practice address:** 1701 PELHAM RD S, JACKSONVILLE, AL 36265-3353
- **Practice address phone:** (256) 435-4970
- **Mailing address:** 7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 02/08/2008