NPI: 1588724033
Provider Name: MEMORIAL SOUTHSIDE CANCER CENTER LLC
Doing Business As: MEMORIAL CANCER CENTER
Classification: Clinic/Center - 261QX0203X
Entity Type: Organization
Specialization: Oncology, Radiation
Address:
5742 BOOTH RD
SUITE B
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 636-6911
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MEMORIAL SOUTHSIDE CANCER CENTER LLC is an oncology and radiation clinic center in Jacksonville, FL. MEMORIAL SOUTHSIDE CANCER CENTER LLC NPI is 1588724033. The provider is registered as an organization entity type.
The provider Is Doing Business As Memorial Cancer Center.
The provider's business location address is:
5742 BOOTH RD
SUITE B
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 636-6911
Fax: (904) 636-6330
The provider's authorized official is Lavelle Hardin .
The authorized official title is Credentialing Coordinator and has the following contact phone number (615) 344-8203.
The enumeration date for this NPI number is 12/12/2006 and was last updated on 1/27/2010.