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General NPI Number Information
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NPI Number | 1023506532
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Entity Type | Organization
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Legal Business Name | ASCENSION SACRED HEART GULF
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 805 HIGHWAY 22
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City | WEWAHITCHKA
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State | FL
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Zip | 32465-3237
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Country | US
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Telephone | 850-568-1053
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Fax | 850-568-1140
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Provider Business Mailing Address
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Address Line | PO BOX 2699 ATTN: SHMG/HPE
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City | PENSACOLA
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State | FL
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Zip | 32513-2699
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Country | US
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Telephone | 850-568-1053
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Fax | 850-568-1140
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Authorized Official
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Title or Position | ENROLLMENT MANAGER
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Name | MIRANDA HEMM
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Credential |
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Telephone | 904-450-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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