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NPI Code Detail

MEDICARE: SACRED HEART HEALTH SYSTEM, INC.

MEDICARE: SACRED HEART HEALTH SYSTEM, 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
1363LF0000XFamily Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
177885OTHERFLBCBS

General Provider Information

NPI Number : 1881134153
Entity Type Code : Organization
Provider Name (Legal Business Name) : SACRED HEART HEALTH SYSTEM, INC.
Provider Business Mailing Address
First Line : PO BOX 2699
Second Line : ATTN: SHMG HPE
City : PENSACOLA
State : FL
Zip : 32513-2699
Country : US
Telephone Number : 850-416-4740
Fax Number : 850-416-4705
Provider Business Practice Location Address
First Line : 2237 W NINE MILE RD
Second Line :
City : PENSACOLA
State : FL
Zip : 32534-9416
Country : US
Telephone Number : 850-416-4740
Fax Number : 850-416-4705
Authorized Official
Title or Position : ENROLLMENT MANAGER
Name : MIRANDA HEMM
Credential :
Telephone Number : 904-450-6004
Provider Enumeration Date : 03/06/2017
Last Update Date : 05/12/2021

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Directions to “SACRED HEART HEALTH SYSTEM, INC. ” Practice Location

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