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General NPI Number Information
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NPI Number | 1679480149
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Entity Type | Organization
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Legal Business Name | PATIENTS FIRST LAKE ELLA MEDICAL CENTER P A
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 4441 BAYOU BLVD
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City | PENSACOLA
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State | FL
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Zip | 32503-2601
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Country | US
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Telephone | 850-332-4246
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Fax |
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Provider Business Mailing Address
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Address Line | 590 LANIER AVE W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1504
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF BILLING OPERATIONS
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Name | SHANDI FAULK
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Credential |
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Telephone | 678-679-6471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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