Healthcare Provider Details

I. General information

NPI: 1669639415
Provider Name (Legal Business Name): MEMORIAL HOSPITAL-WEST VOLUSIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PLYMOUTH AVE
DELAND FL
32720-3236
US

IV. Provider business mailing address

PO BOX 864623
ORLANDO FL
32886-4623
US

V. Phone/Fax

Practice location:
  • Phone: 386-943-4476
  • Fax: 386-943-3685
Mailing address:
  • Phone: 386-671-4519
  • Fax: 386-672-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN ARMSTRONG
Title or Position: CFO
Credential:
Phone: 407-497-8195