Healthcare Provider Details

I. General information

NPI: 1902857352
Provider Name (Legal Business Name): SACRED HEART HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 CARMEL HEIGHTS DR
PENSACOLA FL
32504-8715
US

IV. Provider business mailing address

5225 CARMEL HEIGHTS DR
PENSACOLA FL
32504-8715
US

V. Phone/Fax

Practice location:
  • Phone: 850-475-4620
  • Fax: 850-475-4619
Mailing address:
  • Phone: 850-475-4620
  • Fax: 850-475-4619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MIRANDA HEMM
Title or Position: ENROLLMENT MANAGER
Credential:
Phone: 904-450-6004