1063506111 NPI number — ST FRANCIS MEDICAL BUSINESS SERVICE

Table of content: (NPI 1063506111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063506111 NPI number — ST FRANCIS MEDICAL BUSINESS SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST FRANCIS MEDICAL BUSINESS SERVICE
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:
6
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:
1063506111
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 660284
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:
46266-0001
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:
5255 E STOP 11 RD
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46237-6340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-851-2663
Provider Business Practice Location Address Fax Number:
317-851-2664
Provider Enumeration Date:
10/03/2006

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: 207T00000X , with the licence number:  01062549A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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