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BREVARD HEALTH ALLIANCE INC NPI 1780450759


NPI Information

NPI: 1780450759
Provider Name: BREVARD HEALTH ALLIANCE INC

Doing Business As: FAMILY PROMISE FIREHOUSE CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 10D2291381

Address:
114 1ST ST OFC 137
COCOA, FL
ZIP 32922
Phone: (321) 241-6800
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BREVARD HEALTH ALLIANCE INC is a federally qualified health center (fqhc) clinic center in Cocoa, FL. BREVARD HEALTH ALLIANCE INC NPI is 1780450759. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Promise Firehouse Clinic.

The provider's business location address is:

114 1ST ST OFC 137
COCOA, FL
ZIP 32922-767
Phone: (321) 241-6800
Fax: (321) 241-6890

The provider's authorized official is Angela Craig .
The authorized official title is Director Of Billing and has the following contact phone number (321) 241-6834.

The CLIA number assigned to this NPI record is 10D2291381 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/30/2023 and was last updated on 12/21/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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