Provider Demographics
NPI:1629169362
Name:ST FRANCIS AFFILIATED SERVICES, INC
Entity Type:Organization
Organization Name:ST FRANCIS AFFILIATED SERVICES, INC
Other - Org Name:HOME MEDICAL EQUIPMENT OF ST FRANCIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VICE PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-596-4000
Mailing Address - Street 1:3744 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-5601
Mailing Address - Country:US
Mailing Address - Phone:706-324-2402
Mailing Address - Fax:706-324-1667
Practice Address - Street 1:3744 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5601
Practice Address - Country:US
Practice Address - Phone:706-324-2402
Practice Address - Fax:706-324-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA234173332B00000X, 332BP3500X, 332BX2000X
GA244043335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00308349AMedicaid
GA00308349AMedicaid