1235215252 NPI number — ST FRANCIS MEDICAL CENTER

Table of content: (NPI 1235215252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235215252 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:
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:
1235215252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2015
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:
218-640-3000
Provider Business Mailing Address Fax Number:
218-643-0870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILNOR
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-427-5300
Provider Business Practice Location Address Fax Number:
701-427-5323
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN/PRES
Authorized Official Telephone Number:
218-643-3000

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  338799 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 14779 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".




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