1952331084 NPI number — ST. FRANCIS HOSPITAL AND HEALTH CENTERS

Table of content: (NPI 1952331084)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952331084 NPI number — ST. FRANCIS HOSPITAL AND HEALTH CENTERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. FRANCIS HOSPITAL AND HEALTH CENTERS
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:
SOUTHPORT FAMILY PRACTICE & SPORTS MEDICINE
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:
1952331084
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 664057
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46266-4057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-780-3333
Provider Business Mailing Address Fax Number:
317-780-3345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7855 S EMERSON AVE
Provider Second Line Business Practice Location Address:
SUITE P
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46237-8668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-888-5500
Provider Business Practice Location Address Fax Number:
317-887-4806
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
317-781-3604

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207QS0010X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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