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Organization

ST. VINCENT'S MEDICAL CENTER, INC.

Active
Parent organization
ST. VINCENT'S MEDICAL CENTER, INC.
Other names
ASCENSION ST VINCENT'S RIVERSIDE, Consolidated Laboratory Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST. VINCENT'S MEDICAL CENTER, INC.
Authorized official
JON COOPER (PRESIDENT)
(904) 308-8194
Entity
Organization

Contact information

Practice address
4203 BELFORT RD, SUITE 106, JACKSONVILLE, FL 32216-1409
(904) 308-5600
(904) 296-1589
Mailing address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
(904) 308-2947

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D0645096
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010073102
FL
01
L8520
BCBS FACILITY
FL
Enumeration date
10/24/2006
Last updated
03/21/2022
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