| Ecc Lakeview Campus | |
|
1201 W Hernandez St Building E Pensacola FL 32501-1815 | |
| (850) 469-3890 | |
| (850) 469-3685 |
| Full Name | Ecc Lakeview Campus |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1201 W Hernandez St, Pensacola, Florida |
| Authorized Official Name and Position | Chandra Smiley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8504364630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ecc Lakeview Campus 2315 W Jackson St Pensacola FL 32505-7552 Ph: (850) 436-4630 | Ecc Lakeview Campus 1201 W Hernandez St Building E Pensacola FL 32501-1815 Ph: (850) 469-3890 |
| NPI Number | 1366758088 |
|---|---|
| Provider Enumeration Date | 08/19/2010 |
| Last Update Date | 11/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366758088 | NPI | - | NPPES |
| 692990706 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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