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Rachel Lea Slack

Hospitalist

Allopathic & Osteopathic Physicians

820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205

PECOS Enrollment

This provider is enrolled in PECOS as RACHEL SLACK.

Based on the most recent information from CMS, provider Rachel Lea Slack is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1134757578
Provider Type
Individual
Full Name
Slack, Rachel Lea
Credential
DO

Gender
Female
Sole Proprietor
No
Enumeration Date
3/31/2020
Last Updated
7/20/2023

Contact Information

Practice Location

820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205

(904) 202-3860

(904) 202-3846

Mailing Location

PO Box 746638, Atlanta, GA 30374-6638

(904) 202-1032

(904) 376-4107

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License OS20085 Florida
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License OS20085 Florida

Rachel Lea Slack

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Calvert, Joshua Neal

Romero, Tifinni Marie

Rathod, Sandeep Anil

Doan, Tad C

Mussallam Abu Shaibeh, Sandrela

Thu, Win Min

Anabtawi, Amir

Fulmer, James J.

Naimi, Haroon

Griffin, Robert Laurence