| Epic Community Services, Inc | |
|
1400 Old Dixie Hwy St Augustine FL 32084-4190 | |
| (904) 829-2273 | |
| Not Available |
| Full Name | Epic Community Services, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1400 Old Dixie Hwy, St Augustine, Florida |
| Authorized Official Name and Position | Nangela Pulsfus (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9048292273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Epic Community Services, Inc 3910 Lewis Speedway Ste 1106 St Augustine FL 32084-8649 Ph: (904) 829-2273 | Epic Community Services, Inc 1400 Old Dixie Hwy St Augustine FL 32084-4190 Ph: (904) 829-2273 |
| NPI Number | 1831279280 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 02/21/2024 |
| Certification Date | 02/21/2024 |
| Medicare PECOS PAC ID | 5193254290 |
|---|---|
| Medicare Enrollment ID | O20250117001649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831279280 | NPI | - | NPPES |
| 070827500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 0455AD258200 (Florida) | Primary |
| Provider Name | Robert James Dickinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447851076 PECOS PAC ID: 2769883248 Enrollment ID: I20210622003549 |
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