Organization
GRANNY NANNIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY LAMBERT (ADMINSTRATOR)
(904) 731-2100
Entity
Organization
Contact information
Practice address
9471 BAYMEADOWS RD, SUITE 403, JACKSONVILLE, FL 32256-7932
(904) 731-2100
(904) 731-2177
Mailing address
9471 BAYMEADOWS ROAD, SUITE 403, JACKSONVILLE, FL 32256-7937
(904) 731-2100
(904) 731-2177
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
30211078
FL
Other
Enumeration date
03/19/2012
Last updated
03/19/2012
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