Organization
ARA-WEST JACKSONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
425 N LEE ST, SUITE 103, JACKSONVILLE, FL 32204-1128
(904) 598-2711
(904) 598-2712
Mailing address
425 N LEE ST, SUITE 103, JACKSONVILLE, FL 32204-1128
(904) 598-2711
(904) 598-2712
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890100700
—
FL
Enumeration date
07/13/2006
Last updated
01/10/2023
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