Provider Demographics
NPI:1689611501
Name:ORANGE PARK MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:ORANGE PARK MEDICAL CENTER, INC.
Other - Org Name:HCA FLORIDA ORANGE PARK HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-464-8140
Mailing Address - Street 1:2001 KINGSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5148
Mailing Address - Country:US
Mailing Address - Phone:904-276-8500
Mailing Address - Fax:904-276-8610
Practice Address - Street 1:2001 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5148
Practice Address - Country:US
Practice Address - Phone:904-276-8500
Practice Address - Fax:904-276-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01497965Medicaid
FL11174100Medicaid
FL134OtherBLUE CROSS/HOPT
GA000627965XMedicaid
SC11232AMedicaid
FL16795OtherAMERIGROUP
FL044006OtherAVMED
GA000627965XMedicaid