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General NPI Number Information
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NPI Number | 1568254159
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Entity Type | Organization
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Legal Business Name | SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1061 MEDICAL CENTER DR STE 112
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City | ORANGE CITY
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State | FL
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Zip | 32763-8225
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Country | US
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Telephone | 386-917-7801
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Fax | 386-917-7829
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Provider Business Mailing Address
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Address Line | 1061 MEDICAL CENTER DR STE 112
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City | ORANGE CITY
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State | FL
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Zip | 32763-8225
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Country | US
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Telephone | 386-917-7801
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Fax | 386-917-7829
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Authorized Official
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Title or Position | CFO
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Name | JENNIFER AMBS
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Credential |
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Telephone | 386-917-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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