Organization
904 HEALTH, INC
Active
Parent organization
904 HEALTH INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
904 HEALTH INC
Authorized official
JAMES TARVER (DIRECTOR)
(904) 403-2079
Entity
Organization
Contact information
Practice address
4427 EMERSON ST STE A, JACKSONVILLE, FL 32207-4969
(904) 659-2475
Mailing address
221 N HOGAN ST STE 118, JACKSONVILLE, FL 32202-4201
(904) 900-1513
(904) 575-4944
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
07/28/2023
Last updated
02/04/2025
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