SHANDS JACKSONVILLE MEDICAL CENTER INC NPI 1669560256

NPI Information

NPI: 1669560256
Provider Name: SHANDS JACKSONVILLE MEDICAL CENTER INC

Doing Business As: SHANDS JACKSONVILLE RENAL DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
655 W 8TH ST
BASEMENT, ACC BLDG.
JACKSONVILLE, FL
ZIP 32209
Phone: (904) 244-6690
Get Directions

SHANDS JACKSONVILLE MEDICAL CENTER INC is an end-stage renal disease (esrd) treatment clinic center in Jacksonville, FL. SHANDS JACKSONVILLE MEDICAL CENTER INC NPI is 1669560256. The provider is registered as an organization entity type.
The provider Is Doing Business As Shands Jacksonville Renal Dialysis.

The provider's business location address is:

655 W 8TH ST
BASEMENT, ACC BLDG.
JACKSONVILLE, FL
ZIP 32209-511
Phone: (904) 244-6690
Fax: (904) 244-4431

The provider's authorized official is Michael E Gleason .
The authorized official title is Vp Of Finance And Treasurer and has the following contact phone number (904) 244-8675.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 12/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment		FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	102300	MEDICARE OSCAR/CERTIFICATION	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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