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Organization
MEMORIAL HEALTHCARE GROUP, INC.
Active
Organization
MEMORIAL HEALTHCARE GROUP, INC.
Active
Other names
SPECIALTY HOSPITAL JACKSONVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY WILCOX (CFO)
(904) 730-5756
Entity
Organization
Contact information
Practice address
4901 RICHARD ST, JACKSONVILLE, FL 32207-7328
(904) 737-3120
(904) 730-5991
Mailing address
4901 RICHARD ST, JACKSONVILLE, FL 32207-7328
(904) 737-3120
(904) 730-5991
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000152996X
—
GA
05
—
00404233
—
NY
01
—
044069
AVMED
FL
05
—
10647000
—
FL
01
—
Y34
BLUE CROSS/HOPT
FL
Enumeration date
05/28/2006
Last updated
03/30/2022
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