Healthcare Provider Details
I. General information
NPI: 1982956207
Provider Name (Legal Business Name): WATCH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2012
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 W 1ST ST
ATLANTIC BEACH FL
32233-2502
US
IV. Provider business mailing address
3604 CARDINAL POINT DR
JACKSONVILLE FL
32257-5581
US
V. Phone/Fax
- Phone: 904-249-1984
- Fax: 904-731-0002
- Phone: 904-731-4002
- Fax: 904-731-0002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | 7254 |
| License Number State | FL |
VIII. Authorized Official
Name:
JAMIE
LOUISE
GLAVICH
Title or Position: CEO
Credential:
Phone: 904-610-6602