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General NPI Number Information
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NPI Number | 1801129812
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Entity Type | Organization
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Legal Business Name | RMSC
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 11/15/2009
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Provider Practice Location Address
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Address Line | 1205 MONUMENT RD SUITE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7406
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Country | US
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Telephone | 904-727-1061
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 MONUMENT RD SUITE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7406
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Country | US
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Telephone | 904-727-1061
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. ROGER NOLAN PHILLIPS III
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Credential |
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Telephone | 770-335-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 1318
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License Number State | FL
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