1902878341 NPI number — FRANKLIN HOSPITAL CORPORATION

Table of content: (NPI 1902878341)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902878341 NPI number — FRANKLIN HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLIN HOSPITAL CORPORATION
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:
SOUTHAMPTON MEMORIAL HOSPITAL
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:
1902878341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 503412
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63150-3412
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:
100 FAIRVIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23851-1238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-569-6100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LALOR
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR/DELEGATED OFFICIAL
Authorized Official Telephone Number:
615-925-4565

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H1903 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4900092 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 215197 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004900928 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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