Provider Demographics
NPI:1922681212
Name:SACRED HEART HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:SACRED HEART HEALTH SYSTEM, INC.
Other - Org Name:ASCENSION SACRED HEART URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENROLLMENT
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 1:4205 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1471
Mailing Address - Country:US
Mailing Address - Phone:904-450-6004
Mailing Address - Fax:
Practice Address - Street 1:4033 GULF BREEZE PKWY STE B
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3506
Practice Address - Country:US
Practice Address - Phone:850-416-2641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACRED HEART MEDICAL GROUP URGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-04
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care