Provider Demographics
NPI:1932393717
Name:COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC
Other - Org Name:COMMUNITY PALLIATIVE CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:C
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-268-5200
Mailing Address - Street 1:4266 SUNBEAM RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6030
Mailing Address - Country:US
Mailing Address - Phone:904-407-6231
Mailing Address - Fax:904-407-6033
Practice Address - Street 1:4266 SUNBEAM RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6030
Practice Address - Country:US
Practice Address - Phone:904-407-6231
Practice Address - Fax:904-407-6033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-05
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Multi-Specialty