MEDICARE: ASCENSION HEALTH AT HOME OF FLORIDA II, LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1245812205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENSION HEALTH AT HOME OF FLORIDA II, LLC

Provider Business Mailing Address
First Line	:	10 CADILLAC DR STE 400
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-1001
Country	:	US
Telephone Number	:	615-309-5668
Fax Number	:	615-373-4457

Provider Business Practice Location Address
First Line	:	1115 E GONZALEZ ST STE 10011003
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-6050
Country	:	US
Telephone Number	:	850-266-7235
Fax Number	:	850-502-5417

Authorized Official
Title or Position	:	SVP, CHIEF LEGAL OFFICER
Name	:	RUSSELL ADKINS
Credential	:
Telephone Number	:	615-309-5668

Provider Enumeration Date	:	04/28/2021
Last Update Date	:	06/20/2022

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