Provider Demographics
NPI:1376397539
Name:SAINT FRANCIS MEDICAL CENTER
Entity Type:Organization
Organization Name:SAINT FRANCIS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MSS AND CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:G
Authorized Official - Last Name:WITTENBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-331-3080
Mailing Address - Street 1:211 SAINT FRANCIS DRIVE
Mailing Address - Street 2:SUITE 01512
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703
Mailing Address - Country:US
Mailing Address - Phone:855-213-0007
Mailing Address - Fax:855-213-0052
Practice Address - Street 1:211 SAINT FRANCIS DRIVE
Practice Address - Street 2:SUITE 01512
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703
Practice Address - Country:US
Practice Address - Phone:855-213-0007
Practice Address - Fax:855-213-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy