Organization
NH JACKSONVILLE
Active
Parent organization
NH JACKSONVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
NH JACKSONVILLE
Authorized official
CHRISTINE PANTALEON (UBO MANAGER)
(904) 546-6212
Entity
Organization
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7828
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7828
Taxonomy
Speciality
Code
Description
License number
State
2865M2000X
Military General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090005982
MEDCO
—
01
—
10-88928
NABP
—
01
—
1027809
AETNA
—
01
—
34998
BC PROVIDER
—
01
—
92991
BC PROVIDER
—
01
—
F05
BC PROVIDER
—
Enumeration date
04/25/2006
Last updated
06/11/2025
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