Provider Demographics
NPI:1518071562
Name:JAY HOSPITAL, INC.
Entity Type:Organization
Organization Name:JAY HOSPITAL, INC.
Other - Org Name:JAY HOSPITAL ER PHYSICIANS GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-675-8024
Mailing Address - Street 1:14114 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:FL
Mailing Address - Zip Code:32565-1219
Mailing Address - Country:US
Mailing Address - Phone:850-675-8015
Mailing Address - Fax:
Practice Address - Street 1:14114 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:FL
Practice Address - Zip Code:32565-1219
Practice Address - Country:US
Practice Address - Phone:850-675-8015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036515700Medicaid
FL99097OtherBCBS OF FL
AL559700100Medicaid