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Organization

MEMORIAL HEALTH SYSTEMS INC.

Active
Other names
HCP Radiology Consultants
Organization subpart
No

Provider details

NPI number
Authorized official
CORY DOMAYER (CFO)
(386) 231-3909
Entity
Organization

Contact information

Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-5129
Mailing address
PO BOX 730729, ORMOND BEACH, FL 32173-0729
(386) 671-4500
(386) 672-9904

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
2085N0700X
Neuroradiology Physician
2085N0904X
Nuclear Radiology Physician
2085P0229X
Pediatric Radiology Physician
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005V
BCBS
FL
Enumeration date
08/05/2009
Last updated
03/03/2021
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