CCN: 687295 NPI: 1922718774 Organization

PRUITTHEALTH @ HOME- JACKSONVILLE

4250 LAKESIDE DR
JACKSONVILLE, FL 322103358

Contact Information

Phone 8336795232
Enumeration Date 2022-12-02
Last Updated 2025-10-23

Taxonomies

Code: 251E00000X (Primary)

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 3

cbsaActualGeographicLocation 27260

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 27260

providerType 36

specialPaymentIndicator

carrierCode 09102

localityCode 99