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General NPI Number Information
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NPI Number | 1104818541
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Entity Type | Organization
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Legal Business Name | PENSACOLA HEALTH TRUST INC
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1108 CHURCH ST
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City | SHELBY
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State | MS
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Zip | 38774-2200
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Country | US
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Telephone | 662-398-5117
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Fax | 662-398-7766
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Provider Business Mailing Address
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Address Line | 2 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32502-5631
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Country | US
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Telephone | 850-430-0000
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Fax | 850-436-6766
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | SCOTT J BELL
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Credential |
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Telephone | 850-430-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 438
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License Number State | MS
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