MEDICARE: ESCAMBIA COMMUNITY CLINICS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073174181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESCAMBIA COMMUNITY CLINICS, INC

Provider Business Mailing Address
First Line	:	2315 W JACKSON ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32505-7552
Country	:	US
Telephone Number	:	850-436-4630
Fax Number	:	850-436-2095

Provider Business Practice Location Address
First Line	:	1400 N PALAFOX ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-2643
Country	:	US
Telephone Number	:	850-433-2165
Fax Number	:	850-433-3401

Authorized Official
Title or Position	:	CEO
Name	:	CHANDRA SMILEY
Credential	:
Telephone Number	:	850-436-4630

Provider Enumeration Date	:	06/28/2019
Last Update Date	:	01/06/2026

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