Provider Demographics
NPI:1952326977
Name:AMISUB (SFH), INC.
Entity Type:Organization
Organization Name:AMISUB (SFH), INC.
Other - Org Name:ST. FRANCIS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-765-1000
Mailing Address - Street 1:PO BOX 741274
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1274
Mailing Address - Country:US
Mailing Address - Phone:678-242-2002
Mailing Address - Fax:504-365-2204
Practice Address - Street 1:5959 PARK AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5200
Practice Address - Country:US
Practice Address - Phone:901-765-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000111282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00220213Medicaid
655481970OtherAETNA US HEALTHCARE
1021OtherTENNCARE TLC
GA139978295AMedicaid
440183OtherOMNICARE HEALTH PLAN
84407OtherCOVENTRY HEALTH CARE LOUI
95086OtherBETTER HEALTH
KY01621960Medicaid
440183B000000OtherSECTION 1011
ALSAI0183NMedicaid
216627OtherCOVENTRY HEALTH CARE LOUI
3151805OtherTENNCARE SELECT
FL912032700Medicaid
LA1707511Medicaid
MO010157402Medicaid
AR107150105Medicaid
0009457OtherBCBS OF TENNESSEE
KY01621960Medicaid