Healthcare Provider Details

I. General information

NPI: 1073174181
Provider Name (Legal Business Name): ESCAMBIA COMMUNITY CLINICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N PALAFOX ST
PENSACOLA FL
32501-2643
US

IV. Provider business mailing address

2315 W JACKSON ST
PENSACOLA FL
32505-7552
US

V. Phone/Fax

Practice location:
  • Phone: 850-433-2165
  • Fax: 850-433-3401
Mailing address:
  • Phone: 850-436-4630
  • Fax: 850-436-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHANDRA SMILEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 850-436-4630