Provider Demographics
NPI:1194993949
Name:PARRISH MEDICAL CENTER
Entity type:Organization
Organization Name:PARRISH MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NETWORK COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ROSE ANNE
Authorized Official - Last Name:CHILDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-268-6111
Mailing Address - Street 1:7075 N US HIGHWAY 1
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORT ST JOHN
Mailing Address - State:FL
Mailing Address - Zip Code:32927-5216
Mailing Address - Country:US
Mailing Address - Phone:321-268-6111
Mailing Address - Fax:321-268-0125
Practice Address - Street 1:7075 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-5216
Practice Address - Country:US
Practice Address - Phone:321-433-1439
Practice Address - Fax:321-433-2325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMEIR ORTHOPEDICS GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7071332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies