Healthcare Provider Details

I. General information

NPI: 1770087355
Provider Name (Legal Business Name): ADVENTIST HEALTH SYSTEM-SUNBELT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SUN N LAKE BLVD
SEBRING FL
33872-1986
US

IV. Provider business mailing address

4200 SUN N LAKE BLVD
SEBRING FL
33872-1986
US

V. Phone/Fax

Practice location:
  • Phone: 863-402-3418
  • Fax:
Mailing address:
  • Phone: 863-402-3250
  • Fax: 863-402-3245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH31269
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NATHAN THOMASON
Title or Position: CFO
Credential:
Phone: 863-402-3366