Pensacola Health Trust Inc
Organization Active NPI Skilled Nursing Facility · Shelby, MS
NPI 1104818541 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104818541
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 438 (MS)
- Legal business name
- PENSACOLA HEALTH TRUST INC
- Practice address
- 1108 Church St
Shelby, MS 38774-2200 - Phone
- (662) 398-5117
- Fax
- (662) 398-7766
- NPI assigned
- Aug 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Scott J Bell
- Title
- Ceo President
- Phone
- (850) 430-0000
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Pensacola Health Trust Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 438 | MS | Yes |
Addresses
Primary practice location
1108 Church St
Shelby, MS 38774-2200
Mailing address
2 N Palafox St
Pensacola, FL 32502-5631
Phone (850) 430-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0230112 | Medicaid | MS |
Other names
- Shelby Nursing and Rehab Center
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All providers in Shelby, MS · Skilled Nursing Facility in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.