Provider Demographics
NPI:1639162381
Name:ST. FRANCIS MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. FRANCIS MEDICAL CENTER
Other - Org Name:ST. FRANCIS HEALTHCARE CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-616-3525
Mailing Address - Street 1:2400 ST. FRANCIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:56520
Mailing Address - Country:US
Mailing Address - Phone:218-643-3000
Mailing Address - Fax:218-643-0870
Practice Address - Street 1:2400 ST. FRANCIS DRIVE
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:MN
Practice Address - Zip Code:56520
Practice Address - Country:US
Practice Address - Phone:218-643-3000
Practice Address - Fax:218-643-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331017282NC0060X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND01074Medicaid
MN1556HFROtherBCBS PROVIDER NUMBER
MN5017662OtherMEDICA PROVIDER NUMBER
MN644747300Medicaid
MN2136OtherHEALTH PARTNERS PROV. #
MN2136OtherHEALTH PARTNERS PROV. #
MN240029Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER