Crg34ah01 Llc is a
Pain Medicine - Interventional Pain Medicine based in Jacksonville, Florida. Crg34ah01 Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
4540 Southside Blvd Ste 202, Jacksonville, Florida. It can be reached at their office (for appointments etc.) via phone at
(904) 503-1065.
NPI number for Crg34ah01 Llc is 1265284574 and their current mailing address is 4540 Southside Blvd Ste 202, Jacksonville, Florida. Crg34ah01 Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1265284574.
Healthcare Provider's Profile
| Full Name | Crg34ah01 Llc |
|---|
| Type | Facility |
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| Speciality | Pain Medicine - Interventional Pain Medicine |
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| Location | 4540 Southside Blvd Ste 202, Jacksonville, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1265284574
- Provider Enumeration Date: 04/02/2024
- Last Update Date: 04/02/2024
Medical Identifiers
Medical identifiers for Crg34ah01 Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265284574 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 207XS0117X | Orthopaedic Surgery - Orthopaedic Surgery Of The Spine | (* (Not Available)) | Secondary |
| 207XX0801X | Orthopaedic Surgery - Orthopaedic Trauma | (* (Not Available)) | Secondary |
| 2084P0301X | Psychiatry & Neurology - Brain Injury Medicine | (* (Not Available)) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crg34ah01 Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Crg34ah01 Llc
4540 Southside Blvd Ste 202,
Jacksonville, FL 32216-5488
Ph: (904) 503-1065 | Crg34ah01 Llc
4540 Southside Blvd Ste 202,
Jacksonville, FL 32216-5488
Ph: (904) 503-1065 |
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