Healthcare Provider Details

I. General information

NPI: 1649367269
Provider Name (Legal Business Name): MEMORIAL HOSPITAL-WEST VOLUSIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W. PLYMOUTH AVENUE
DELAND FL
32720-3236
US

IV. Provider business mailing address

770 W GRANADA BLVD STE 203
ORMOND BEACH FL
32174-5179
US

V. Phone/Fax

Practice location:
  • Phone: 386-943-4522
  • Fax: 386-943-3674
Mailing address:
  • Phone: 386-943-4522
  • Fax: 386-943-3674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4436
License Number StateFL

VIII. Authorized Official

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