MEDICARE: CAN COMMUNITY HEALTH, INC.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	207R00000X	Internal Medicine Physician
4	363AM0700X	Medical Physician Assistant
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
6	207RI0200X	Infectious Disease Physician

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	21725	OTHER	FL	FL BCB GROUP #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1437726775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAN COMMUNITY HEALTH, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1000 DEPT 394
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38148-1926
Country	:	US
Telephone Number	:	941-300-4440
Fax Number	:	941-404-1760

Provider Business Practice Location Address
First Line	:	8390 N PALAFOX ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-3735
Country	:	US
Telephone Number	:	850-988-5245
Fax Number	:	877-266-7170

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	RISHI B PATEL
Credential	:
Telephone Number	:	941-300-4440

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	01/30/2024

8382 N PALAFOX ST
PENSACOLA, FL
32534-3735

Practice Phone: 850-982-9118
Practice Fax: