Organization
ESCAMBIA COMMUNITY CLINICS INC
Active
Parent organization
ESCAMBIA COMMUNITY CLINICS INC
Other names
Cantonment Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESCAMBIA COMMUNITY CLINICS INC
Authorized official
CHANDRA SMILEY (EXECUTIVE DIRECTOR)
(850) 436-4630
Entity
Organization
Contact information
Practice address
470 S HIGHWAY 29 STE 2, CANTONMENT, FL 32533
(850) 780-0111
(850) 780-0642
Mailing address
2315 W JACKSON ST, PENSACOLA, FL 32505-7552
(850) 436-4630
(850) 436-2095
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692990721
—
FL
Enumeration date
05/20/2016
Last updated
11/30/2018
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