Organization
EDGEWOOD NURSING CENTER INC
Active
Other names
EdgeWood Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HAGAN (PRESIDENT)
(770) 993-4000
Entity
Organization
Contact information
Practice address
1771 EDGEWOOD AVE W, JACKSONVILLE, FL 32208-3278
(904) 766-7436
(904) 766-5749
Mailing address
995 CANTON ST STE 100, ROSWELL, GA 30075-4240
(770) 993-4000
(904) 766-5749
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025487800
—
FL
Enumeration date
08/10/2005
Last updated
07/18/2019
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