Provider Demographics
NPI:1356690465
Name:ST. FRANCIS CVC LLC
Entity Type:Organization
Organization Name:ST. FRANCIS CVC LLC
Other - Org Name:CHATTAHOOCHEE VALLEY CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/SVP
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:S
Authorized Official - Last Name:HEMBREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-320-3751
Mailing Address - Street 1:PO BOX 9265
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-9265
Mailing Address - Country:US
Mailing Address - Phone:706-565-7382
Mailing Address - Fax:
Practice Address - Street 1:2300 MANCHESTER EXPY
Practice Address - Street 2:SUITE 1003
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6877
Practice Address - Country:US
Practice Address - Phone:706-565-7382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003129221AMedicaid
AL141848Medicaid
GA202G709438Medicare PIN