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General NPI Number Information
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NPI Number | 1841343340
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Entity Type | Organization
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Legal Business Name | SACRED HEART HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6701 AIRPORT BLVD SUITE 143
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 850-470-9288
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Fax | 850-470-9130
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Provider Business Mailing Address
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Address Line | 6701 AIRPORT BLVD SUITE 143
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 850-470-9288
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Fax | 850-470-9130
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CONSTANCE HETTERICH
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Credential | R.N.
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Telephone | 850-470-9288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2006-004168
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License Number State | AL
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