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Contact Information

THE APOTHECARY AT MEMORIAL
3627 UNIVERSITY BLVD S
JACKSONVILLE, FL32216-4230
 Phone: 904-702-6171
 Fax: 904-702-6004
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Corporate Health

261QC1800X
Indicates primary specialty

NPI Profile & details for THE APOTHECARY AT MEMORIAL

NPI Number 1508966649
LBN Legal business name THE APOTHECARY AT MEMORIAL
Authorized official KEVIN MCKEOWN - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/25/2006
Last updated 03/30/2022 - About 4 years ago
Identifiers
FL License # PH 8064
FL Medicaid 109647800
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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