Provider Demographics
NPI:1285981548
Name:SACRED HEART HEALTH SYSTEM
Entity type:Organization
Organization Name:SACRED HEART HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-416-0025
Mailing Address - Street 1:13137 SORRENTO RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8777
Mailing Address - Country:US
Mailing Address - Phone:850-416-0025
Mailing Address - Fax:850-487-9830
Practice Address - Street 1:13137 SORRENTO RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8777
Practice Address - Country:US
Practice Address - Phone:850-416-0025
Practice Address - Fax:850-487-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22127273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit