Provider Demographics
NPI:1356817910
Name:ST VINCENT INFIRMARY MEDICAL CENTER
Entity Type:Organization
Organization Name:ST VINCENT INFIRMARY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-552-3929
Mailing Address - Street 1:2 SAINT VINCENT CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5423
Mailing Address - Country:US
Mailing Address - Phone:501-552-3155
Mailing Address - Fax:
Practice Address - Street 1:10001 LILE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6217
Practice Address - Country:US
Practice Address - Phone:501-227-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical