Provider Demographics
NPI:1437188034
Name:SAINT FRANCIS MEDICAL CENTER
Entity Type:Organization
Organization Name:SAINT FRANCIS MEDICAL CENTER
Other - Org Name:SAINT FRANCIS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILLILAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-331-5583
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5180
Mailing Address - Fax:573-331-5006
Practice Address - Street 1:150 S MOUNT AUBURN RD STE 344
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4917
Practice Address - Country:US
Practice Address - Phone:573-331-5180
Practice Address - Fax:573-331-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00010679251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO588608307Medicaid
MO46165OtherCMR
AK145908105OtherARKANSAS CAID
MO588608307Medicaid
MO01060802Medicaid
MO110375OtherHEALTHLINK
MO153OtherBLUE CROSS/SHIELD #
MO46165OtherCMR
KY01440833OtherKENTUCKY CAID
MO3623OtherHEALTH ALLIANCE
MO46165OtherGHP
MO46165OtherGHP
MO46165OtherCMR
KY=========OtherKENTUCKY CAID-DR
MO3623OtherHEALTH ALLIANCE