| Fairfield | |
|
1295 W Fairfield Dr Pensacola FL 32501-1107 | |
| (850) 912-8880 | |
| (850) 912-8779 |
| Full Name | Fairfield |
|---|---|
| Speciality | Clinic/Center |
| Location | 1295 W Fairfield Dr, Pensacola, Florida |
| Authorized Official Name and Position | Chandra Smiley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8504364630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfield 2315 W Jackson St Pensacola FL 32505-7552 Ph: (850) 436-4630 | Fairfield 1295 W Fairfield Dr Pensacola FL 32501-1107 Ph: (850) 912-8880 |
| NPI Number | 1770911505 |
|---|---|
| Provider Enumeration Date | 10/14/2013 |
| Last Update Date | 11/30/2018 |
| Medicare PECOS PAC ID | 9638165806 |
|---|---|
| Medicare Enrollment ID | O20160301000483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770911505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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