Healthcare Provider Details

I. General information

NPI: 1811145485
Provider Name (Legal Business Name): MSC GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 PRUDENTIAL DR STE 204
JACKSONVILLE FL
32207-8347
US

IV. Provider business mailing address

841 PRUDENTIAL DR STE 204
JACKSONVILLE FL
32207-8347
US

V. Phone/Fax

Practice location:
  • Phone: 904-646-0199
  • Fax:
Mailing address:
  • Phone: 904-646-0199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN DAVIS
Title or Position: CHIEF LEGAL OFFICER
Credential: J.D.
Phone: 904-848-1989