Provider Demographics
NPI:1629846555
Name:BAPTIST MEDICAL CENTER OF NASSAU, INC.
Entity type:Organization
Organization Name:BAPTIST MEDICAL CENTER OF NASSAU, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP/CRO
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-376-3760
Mailing Address - Street 1:PO BOX 746634
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6634
Mailing Address - Country:US
Mailing Address - Phone:904-376-4149
Mailing Address - Fax:904-618-2159
Practice Address - Street 1:462600 STATE ROAD 200
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-5494
Practice Address - Country:US
Practice Address - Phone:904-376-4149
Practice Address - Fax:904-618-2159
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST MEDICAL CENTER OF NASSAU, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-20
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital