1932206455 NPI number — ST FRANCIS HOSPITAL

Table of content: (NPI 1932206455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932206455 NPI number — ST FRANCIS HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST FRANCIS HOSPITAL
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:
ST. FRANCIS PROFESSIONAL SERVICES
Provider Other Organization Name Type Code:
3
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:
1932206455
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
124 SW ADAMS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61602-1320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-655-2850
Provider Business Mailing Address Fax Number:
309-655-4878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3401 LUDINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESCANABA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49829-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-786-3311
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SEHRING
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO, OSF HEALTHCARE SYSTEM
Authorized Official Telephone Number:
309-655-7804

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12264 . This is a "PRIORITY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 23006 . This is a "COMMUNITY CHOICE MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: CE9198 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 025940 . This is a "MIDWEST HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0B16009 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: XX25063 . This is a "HEALTHPLUS OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 134080905 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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