1639162381 NPI number — ST. FRANCIS MEDICAL CENTER

Table of content: (NPI 1639162381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639162381 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:
1639162381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2400 ST. FRANCIS DRIVE
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
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-643-3000
Provider Business Mailing Address Fax Number:
218-643-0870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 ST. FRANCIS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRECKENRIDGE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-643-3000
Provider Business Practice Location Address Fax Number:
218-643-0870
Provider Enumeration Date:
08/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ROSS
Authorized Official First Name:
JAY
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
VP OF FINANCE OPERATION
Authorized Official Telephone Number:
218-616-3525

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  331017 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01074 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1556HFR . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5017662 . This is a "MEDICA PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 644747300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2136 . This is a "HEALTH PARTNERS PROV. #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com