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General NPI Number Information
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NPI Number | 1285323352
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH PACE OF PENSACOLA INC
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 5020 COMMERCE PARK CIR
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City | PENSACOLA
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State | FL
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Zip | 32505-1869
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Country | US
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Telephone | 850-806-0900
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Fax | 850-806-0901
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Provider Business Mailing Address
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Address Line | 5020 COMMERCE PARK CIR
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City | PENSACOLA
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State | FL
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Zip | 32505-1869
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Country | US
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Telephone | 850-806-0900
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Fax | 850-806-0901
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TRAVIS GARRETT
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Credential | MBA, BSN, RN
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Telephone | 850-806-0830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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