Provider Demographics
NPI:1285323352
Name:TRINITY HEALTH PACE OF PENSACOLA INC
Entity type:Organization
Organization Name:TRINITY HEALTH PACE OF PENSACOLA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, BSN, RN
Authorized Official - Phone:850-806-0830
Mailing Address - Street 1:5020 COMMERCE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-1869
Mailing Address - Country:US
Mailing Address - Phone:850-806-0900
Mailing Address - Fax:850-806-0901
Practice Address - Street 1:5020 COMMERCE PARK CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-1869
Practice Address - Country:US
Practice Address - Phone:850-806-0900
Practice Address - Fax:850-806-0901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY HEALTH PACE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-04
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization