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General NPI Number Information
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NPI Number | 1477953917
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Entity Type | Organization
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Legal Business Name | SACRED HEART HEALTH SYSTEM
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 4530 BALMORAL DR
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City | PENSACOLA
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State | FL
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Zip | 32504-9103
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Country | US
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Telephone | 850-723-9095
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Fax |
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Provider Business Mailing Address
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Address Line | 5151 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-8721
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Country | US
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Telephone | 850-416-7000
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MRS. PAMELA KHASUNGU KULOBA
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Credential | RN
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Telephone | 850-723-9095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | RN 9193159
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License Number State | FL
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