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Organization

ASCENSION SACRED HEART GULF

Active
Other names
Ascension Sacred Heart Gulf
Organization subpart
No

Provider details

NPI number
Authorized official
COBA SUSAN CORNEJO (COO)
(850) 416-6206
Entity
Organization

Contact information

Practice address
3801 E HIGHWAY 98, PORT ST JOE, FL 32456-5318
(850) 229-5600
(850) 416-7453
Mailing address
7928 SOLUTION CTR, LOCKBOX 777928, CHICAGO, IL 60677-7009
(850) 416-7190
(850) 416-7453

Taxonomy

Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
FL
282NR1301X
Rural Acute Care Hospital
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002012700
FL
01
159
BLUE CROSS OF FL
FL
Enumeration date
11/03/2009
Last updated
03/05/2021
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