Healthcare Provider Details

I. General information

NPI: 1215118062
Provider Name (Legal Business Name): ACCMED HEALTHCARE SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 11/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6816 SOUTHPOINT PKWY SUITE 302
JACKSONVILLE FL
32216-1700
US

IV. Provider business mailing address

5377 COMMISSIONERS DR
JACKSONVILLE FL
32224-0830
US

V. Phone/Fax

Practice location:
  • Phone: 904-527-3135
  • Fax: 904-683-4293
Mailing address:
  • Phone: 904-527-3135
  • Fax: 904-683-7986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: BAO PHAM
Title or Position: CEO
Credential: DO
Phone: 904-527-3135