Provider Demographics
NPI:1073165924
Name:SAINT FRANCIS MEDICAL CENTER
Entity Type:Organization
Organization Name:SAINT FRANCIS MEDICAL CENTER
Other - Org Name:SAINT FRANCIS OUTPATIENT CENTER IMAGING - POPLAR BLUFF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:G
Authorized Official - Last Name:WITTENBORN
Authorized Official - Suffix:
Authorized Official - Credentials:CPCS
Authorized Official - Phone:573-331-3080
Mailing Address - Street 1:SAINT FRANCIS MEDICAL CENTER
Mailing Address - Street 2:211 SAINT FRANCIS DRIVE
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:223 PHYSICIANS PARK
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3956
Practice Address - Country:US
Practice Address - Phone:573-331-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography