CCN: 687208 NPI: 1023603503 Organization

Phenomenal Healthcare, LLC

6815 ATLANTIC BLVD STE 3
JACKSONVILLE, FL 322118764

Contact Information

Phone 9044385837
Enumeration Date 2021-03-05
Last Updated 2022-03-08

Taxonomies

Code: 251E00000X
Code: 253Z00000X (Primary)

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 3

cbsaActualGeographicLocation 27260

providerType 36

censusDivision 3

cbsaActualGeographicLocation 27260

providerType 36

censusDivision 3

cbsaActualGeographicLocation 27260

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 27260

providerType 36

carrierCode 09102

localityCode 99