| Ecc At Waterfront Rescue Mission | |
|
350 W Herman St Pensacola FL 32505-5249 | |
| (850) 332-5900 | |
| (850) 332-6889 |
| Full Name | Ecc At Waterfront Rescue Mission |
|---|---|
| Speciality | Clinic/Center |
| Location | 350 W Herman St, Pensacola, Florida |
| Authorized Official Name and Position | Chandra Smiley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8504364630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ecc At Waterfront Rescue Mission 2315 W Jackson St Pensacola FL 32505-7552 Ph: (850) 436-4630 | Ecc At Waterfront Rescue Mission 350 W Herman St Pensacola FL 32505-5249 Ph: (850) 332-5900 |
| NPI Number | 1225469398 |
|---|---|
| Provider Enumeration Date | 11/27/2013 |
| Last Update Date | 08/13/2021 |
| Medicare PECOS PAC ID | 9638165806 |
|---|---|
| Medicare Enrollment ID | O20160301000155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225469398 | NPI | - | NPPES |
| 692990716 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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