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General NPI Number Information
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NPI Number | 1861782443
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Entity Type | Organization
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Legal Business Name | STAT HOME HEALTH FLORIDA PANHANDLE, LLC
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Dates
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Enumeration Date | 04/15/2011
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 127 S ALCANIZ ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6009
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Country | US
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Telephone | 850-857-1869
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Fax | 850-857-1889
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Provider Business Mailing Address
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Address Line | 10615 JEFFERSON HWY
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City | BATON ROUGE
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State | LA
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Zip | 70809-7230
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Country | US
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Telephone | 225-769-2449
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Fax | 225-757-1104
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. PATRICK MITCHELL
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Credential | CEO
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Telephone | 225-749-2449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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