Provider Demographics
NPI:1619190204
Name:ST. FRANCIS MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:ST. FRANCIS MEDICAL CENTER, INC
Other - Org Name:FRANCISCAN HOUSE ADULT DAY HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:REIMBURSEMENT ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-327-7279
Mailing Address - Street 1:101 SOUTH 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-322-3635
Mailing Address - Fax:
Practice Address - Street 1:101 SOUTH 4TH STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-322-3635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAADHC261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1327484Medicaid