Organization
904 HEALTH, INC
Active
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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