Organization
ACV COMMUNITY SERVICES LLC
Active
Other names
Copeland Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG A. CARTER (PRESIDENT/CEO)
(386) 658-5500
Entity
Organization
Contact information
Practice address
10820 MARVIN E. JONES BLVD., LIVE OAK, FL 32060-5890
(386) 658-5550
(386) 658-5666
Mailing address
PO BOX 4675, DOWLING PARK, FL 32064-1507
(386) 658-5450
(386) 658-5111
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029511600
—
FL
01
—
230620
AVMED
FL
05
—
379125400
—
FL
01
—
W01
BCBS CLINIC UB92
FL
Enumeration date
08/23/2006
Last updated
10/06/2008
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