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WATERCANAL ER SVCS PARTNERSHIP LLC NPI 1073561379


NPI Information

NPI: 1073561379
Provider Name: WATERCANAL ER SVCS PARTNERSHIP LLC
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
60 MEMORIAL MEDICAL PKWY
PALM COAST, FL
ZIP 32164
Phone: (386) 586-2010
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WATERCANAL ER SVCS PARTNERSHIP LLC is an emergency medicine in Palm Coast, FL. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. WATERCANAL ER SVCS PARTNERSHIP LLC NPI is 1073561379. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

60 MEMORIAL MEDICAL PKWY
PALM COAST, FL
ZIP 32164-980
Phone: (386) 586-2010
Fax: (386) 676-4248

The provider's authorized official is Joseph H. Gatewood .
The authorized official title is President and has the following contact phone number (469) 401-2386.

The enumeration date for this NPI number is 5/5/2006 and was last updated on 6/20/2014.


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
1207P00000XEmergency MedicineYes

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
1Q0427MEDICARE PINFLORIDA
2275953500MEDICAIDFLORIDA
372262OTHERFLORIDABLUE SHIELD
4DF4370MEDICARE PINFLORIDA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.