1891954574 NPI number — ST FRANCIS MEDICAL CENTER

Table of content: (NPI 1891954574)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891954574 NPI number — ST FRANCIS MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST FRANCIS MEDICAL CENTER
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:
Provider Other Organization Name Type Code:
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:
1891954574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2400 ST FRANCIS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRECKENRIDGE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56520-1025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 ST FRANCIS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRECKENRIDGE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56520-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-643-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EHRENS
Authorized Official First Name:
ANA
Authorized Official Middle Name:
Authorized Official Title or Position:
PATIENT FINANCIAL SERVICES COOR.
Authorized Official Telephone Number:
218-643-0312

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 207001 . This is a "BCBS NORTH DAKOTA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 53764FR . This is a "BCBS MINNESOTA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 17161 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".