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Organization
HEALTHSTAT PENSACOLA LLC
Active
Organization
HEALTHSTAT PENSACOLA LLC
Active
Other names
Healthstat On-Site Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KINZLER (EVP SALES & MARKETING)
(704) 529-6161
Entity
Organization
Contact information
Practice address
1678 AIRPORT BLVD, PENSACOLA, FL 32504-8618
(850) 479-3790
(850) 479-3920
Mailing address
4601 CHARLOTTE PARK DR, SUITE 390, CHARLOTTE, NC 28217-1915
(704) 529-6161
(704) 936-5570
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5706657
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/20/2011
Last updated
10/04/2011
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