Memorial Cancer Center

LBN: Memorial Southside Cancer Center Llc
Memorial Cancer Center is an health care organization with primary practice located at 5742 Booth Rd Suite B, Jacksonville FL 32207. The organization recently has only one registered license in Ambulatory Health Care Facilities / Oncology, Radiation, which is considered as the primary health care specialty. Memorial Southside Cancer Center Llc can be contacted via phone (904) 636-6911, or through Hardin, Lavelle via phone (615) 344-8203.

Contact Information

Primary practice address
5742 Booth Rd Suite B Jacksonville FL 32207
Phone: (904) 636-6911
Fax: (904) 636-6330
Website:
Map and Directions
Authorized official contact:
Name: Hardin, Lavelle
Phone: (615) 344-8203

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Oncology, Radiation 261QX0203X APPLYING Florida

Profile Details

NPI number 1588724033
LBN Legal business name Memorial Southside Cancer Center Llc
DBA Doing business as Memorial Cancer Center
Authorized official Hardin, Lavelle
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2006
Last updated Jan 27th, 2010 - about 15 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 1588724033 NPPES
Florida Other DG1361 RR MEDICARE
Florida Other 00389 RR MEDICARE
Florida MEDICAID 277325200 RR MEDICARE

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