Provider Demographics
NPI:1518518042
Name:HYPERBARIC HEALTH SERVICES - PALATKA LLC
Entity Type:Organization
Organization Name:HYPERBARIC HEALTH SERVICES - PALATKA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:CHS
Authorized Official - Phone:386-385-3857
Mailing Address - Street 1:608 POINSETTIA ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6849
Mailing Address - Country:US
Mailing Address - Phone:904-540-8797
Mailing Address - Fax:904-797-2852
Practice Address - Street 1:524 ZEAGLER DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3813
Practice Address - Country:US
Practice Address - Phone:386-385-3857
Practice Address - Fax:904-530-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty