NPIMap

Organization Active NPI

The Apothecary at Memorial

Doing business as HCA Florida Memorial Hospital

  • Corporate Health Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1508966649
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corporate Health Clinic/CenterTaxonomy code 261QC1800X
License
PH 8064 Issued in FL
Legal business name
THE APOTHECARY AT MEMORIAL
Doing business as
HCA Florida Memorial Hospital
Practice address
3627 University Blvd S
Jacksonville, FL 32216-4230
Phone
(904) 702-6171
Fax
(904) 702-6004
NPI assigned
Sep 25, 2006
Last updated
Mar 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HEALTHCARE GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin McKeown
Title
Cfo
Phone
(904) 702-6573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corporate Health Clinic/Center 261QC1800X PH 8064 FL Primary

Addresses

Primary practice location

3627 University Blvd S
Jacksonville, FL 32216-4230

Mailing address

3627 University Blvd S
Jacksonville, FL 32216-4230
Phone (904) 702-6171

Other identifiers 1

IdentifierTypeStateIssuer
109647800MedicaidFL

Other names 1

  • HCA Florida Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Memorial Laboratories14 organizations share this tax ID, including this one
Part of
Memorial Laboratories

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

3627 University Blvd S
Jacksonville, FL 32216
Phone (904) 396-0300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1508966649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-702-6171",
            "fax_number": "904-702-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-702-6171",
            "fax_number": "904-702-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE APOTHECARY AT MEMORIAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTHCARE GROUP, INC.",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "MCKEOWN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-702-6573"
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "FL",
            "license": "PH 8064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109647800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HCA Florida Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.