# ACTIVE INNOVATIONS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KeyMed
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467633495
- **Authorized official:** MR. BRYAN K JACOBS (OWNER/PRESIDENT)
- **Authorized official phone:** (904) 541-0207

## Contact information

- **Practice address:** 1892 BELLAIR BLVD, ORANGE PARK, FL 32073-4548
- **Practice address phone:** (904) 541-0207
- **Practice address fax:** (904) 269-8373
- **Mailing address:** 1892 BELLAIR BLVD, ORANGE PARK, FL 32073-4548
- **Mailing address phone:** (904) 541-0207
- **Mailing address fax:** (904) 269-8373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 11/19/2007
- **Last updated:** 11/19/2007