Provider Demographics
NPI:1639406267
Name:FLORENCE HOSPITAL, LLC
Entity Type:Organization
Organization Name:FLORENCE HOSPITAL, LLC
Other - Org Name:FLORENCE COMMUNITY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-494-3237
Mailing Address - Street 1:1300 E STATE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-7059
Mailing Address - Country:US
Mailing Address - Phone:520-494-3237
Mailing Address - Fax:520-868-3329
Practice Address - Street 1:1300 E STATE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7059
Practice Address - Country:US
Practice Address - Phone:520-494-3237
Practice Address - Fax:520-868-3329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE OF FLORENCE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-03
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPPLIED FOR282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access