Provider Demographics
NPI:1528539061
Name:SACRED HEART HEALTH SYSTEM, INC.
Entity type:Organization
Organization Name:SACRED HEART HEALTH SYSTEM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-450-6004
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN SHMG HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506
Mailing Address - Country:US
Mailing Address - Phone:850-475-4682
Mailing Address - Fax:850-475-4619
Practice Address - Street 1:5153 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8785
Practice Address - Country:US
Practice Address - Phone:850-416-1575
Practice Address - Fax:850-416-1302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACRED HEART HEALTH SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-10
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty