1437149168 NPI number — ST FRANCIS MEDICAL CENTER, INC

Table of content: (NPI 1437149168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437149168 NPI number — ST FRANCIS MEDICAL CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST FRANCIS MEDICAL CENTER, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EKG SERVICES & HOSPITAL BASED PHYSICIANS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437149168
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1901
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71210-1901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-327-4255
Provider Business Mailing Address Fax Number:
318-327-4764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
309 JACKSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71201-7407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-327-4255
Provider Business Practice Location Address Fax Number:
318-327-4764
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HOGAN
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO/SR VP
Authorized Official Telephone Number:
318-327-7369

Provider Taxonomy Codes

  • Taxonomy code: 2080N0001X , with the licence number:  157 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 157 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208800000X , with the licence number: 157 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1796069 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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