MEDICARE: THE NEMOURS FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QD1600X	Developmental Disabilities Clinic/Center
2	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
3	261QG0250X	Genetics Clinic/Center
4	261QH0700X	Hearing and Speech Clinic/Center
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	261QM2500X	Medical Specialty Clinic/Center
7	261QP2300X	Primary Care Clinic/Center
8	261QR0200X	Radiology Clinic/Center
9	261QR1100X	Research Clinic/Center
10	284300000X	Special Hospital
11	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1386658615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEMOURS FOUNDATION

Provider Business Mailing Address
First Line	:	10140 CENTURION PKWY N
Second Line	:	MANAGED CARE DEPARTMENT
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-5628
Fax Number	:	907-697-5629

Provider Business Practice Location Address
First Line	:	10140 CENTURION PKWY N
Second Line	:	THE NEMOURS FOUNDATION
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-5628
Fax Number	:	907-697-5629

Authorized Official
Title or Position	:	VP, FINANCE
Name	:	MR. RODNEY A MCKENDREE
Credential	:
Telephone Number	:	904-697-5628

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	10/29/2012

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Directions to “THE NEMOURS FOUNDATION ” Practice Location

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