Healthcare Provider Details

I. General information

NPI: 1609823194
Provider Name (Legal Business Name): SACRED HEART HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 E WRIGHT ST
PENSACOLA FL
32501-4917
US

IV. Provider business mailing address

213 E WRIGHT ST
PENSACOLA FL
32501-4917
US

V. Phone/Fax

Practice location:
  • Phone: 850-470-9288
  • Fax: 850-470-9130
Mailing address:
  • Phone: 850-470-9288
  • Fax: 850-470-9130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA299990987
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1018
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2006-004168
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH-0015794
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number112391
License Number StateAL
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA20476096
License Number StateFL

VIII. Authorized Official

Name: MS. JANET FRY
Title or Position: ADMINISTRATOR
Credential:
Phone: 850-470-9288