Organization
MEMORIAL HEALTHCARE GROUP, INC.
Active
Other names
SPECIALTY HOSPITAL JACKSONVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY WILCOX (CFO)
(904) 730-5756
Entity
Organization
Contact information
Practice address
4901 RICHARD ST, JACKSONVILLE, FL 32207-7328
(904) 737-3120
(904) 730-5991
Mailing address
4901 RICHARD ST, JACKSONVILLE, FL 32207-7328
(904) 737-3120
(904) 730-5991
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000152996X
—
GA
05
—
00404233
—
NY
01
—
044069
AVMED
FL
05
—
10647000
—
FL
01
—
Y34
BLUE CROSS/HOPT
FL
Enumeration date
05/28/2006
Last updated
03/30/2022
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