Provider Demographics
NPI:1477953917
Name:SACRED HEART HEALTH SYSTEM
Entity Type:Organization
Organization Name:SACRED HEART HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:KHASUNGU
Authorized Official - Last Name:KULOBA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:850-723-9095
Mailing Address - Street 1:5151 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8721
Mailing Address - Country:US
Mailing Address - Phone:850-416-7000
Mailing Address - Fax:
Practice Address - Street 1:4530 BALMORAL DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-9103
Practice Address - Country:US
Practice Address - Phone:850-723-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9193159282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital