MEDICARE: ESCAMBIA CO BOARD OF COUNTY COMMISS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	002538	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518960426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESCAMBIA CO BOARD OF COUNTY COMMISS

Provider Business Mailing Address
First Line	:	6575 N W ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32505-1714
Country	:	US
Telephone Number	:	850-471-6508
Fax Number	:	850-471-6515

Provider Business Practice Location Address
First Line	:	6575 N W ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32505-1714
Country	:	US
Telephone Number	:	850-471-6508
Fax Number	:	850-471-6515

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	SHANDRA JENKINS
Credential	:
Telephone Number	:	850-471-6508

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/15/2021

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