Family Health Source

LBN: Northeast Florida Health Services Inc
Family Health Source is an health care organization with primary practice located at 1205 S Woodland Blvd Ste 5 , Deland FL 32720-7464. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Northeast Florida Health Services Inc can be contacted via phone (386) 202-6025, or through Asbury, Laurie via phone (386) 202-6025.

Contact Information

Primary practice address
1205 S Woodland Blvd Ste 5 Deland FL 32720-7464
Phone: (386) 202-6025
Fax: (386) 269-1847
Website:
Map and Directions
Authorized official contact:
Name: Asbury, Laurie
Phone: (386) 202-6025

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X Florida

Profile Details

NPI number 1063903672
LBN Legal business name Northeast Florida Health Services Inc
DBA Doing business as Family Health Source
Authorized official Asbury, Laurie
Entity Organization
Organization subpart 1 Yes
Enumeration date May 21st, 2018
Last updated May 6th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063903672 NPPES
Florida MEDICAID 102004200

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