First Coast Ltc, Inc

LBN: First Coast Ltc, Inc
First Coast Ltc, Inc is an health care organization with primary practice located at 25 State Road 13 Att: Clinic, Saint Johns FL 32259-2842. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. First Coast Ltc, Inc can be contacted via phone (904) 309-6504, or through Samara, David via phone (904) 309-6504.

Contact Information

Primary practice address
25 State Road 13 Att: Clinic Saint Johns FL 32259-2842
Phone: (904) 309-6504
Fax: (904) 503-3577
Website:
Map and Directions
Authorized official contact:
Name: Samara, David Doctor of Medicine (MD)
Phone: (904) 309-6504

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X ME31637 Florida

Profile Details

NPI number 1538418868
LBN Legal business name First Coast Ltc, Inc
DBA Doing business as
Authorized official Samara, David Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 31st, 2012
Last updated Mar 7th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538418868 NPPES
Florida MEDICAID 371340700
Florida Other CG-1814

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