Healthcare Provider Details

I. General information

NPI: 1952352304
Provider Name (Legal Business Name): SACRED HEART HOSPITAL OF PENSACOLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4451 BAYOU BLVD
PENSACOLA FL
32503-2601
US

IV. Provider business mailing address

PO BOX 2699
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-475-4500
  • Fax: 850-475-4781
Mailing address:
  • Phone: 850-475-4738
  • Fax: 850-475-4619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. LAURA IRWIN
Title or Position: VICE PRESIDENT
Credential: FACMPE
Phone: 850-416-6638