1639116726 NPI number — WEST FLORIDA REGIONAL MEDICAL CENTER, INC.

Table of content: (NPI 1639116726)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639116726 NPI number — WEST FLORIDA REGIONAL MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST FLORIDA REGIONAL MEDICAL CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639116726
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 18900
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32523-8900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-494-4100
Provider Business Mailing Address Fax Number:
850-494-4141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8383 N DAVIS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32514-6039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-494-4100
Provider Business Practice Location Address Fax Number:
850-494-4141
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SUITT
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
850-494-4685

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010168 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 117315 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 000108787A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 215500 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: HOS0231P , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00407089 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0465303 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11321200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: Z436 . This is a "BLUE CROSS/HOPT" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 011321200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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