Organization
ST LUKES - ST VINCENTS HEALTHCARE
Active
Other names
Ascension Rx 1402
Organization subpart
No
Provider details
NPI number
Authorized official
COBA SUSAN CORNEJO (CHIEF OPERATING OFFICER)
(803) 463-5837
Entity
Organization
Contact information
Practice address
4205 BELFORT RD STE 1003, JACKSONVILLE, FL 32216-5876
(904) 450-6330
(833) 347-0804
Mailing address
4201 BELFORT RD STE G361, JACKSONVILLE, FL 32216-1431
(904) 450-6330
(833) 347-0804
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/14/2013
Last updated
04/10/2025
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