Provider Demographics
NPI:1255419651
Name:ST. FRANCIS MEDICAL CENTER
Entity type:Organization
Organization Name:ST. FRANCIS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-599-5119
Mailing Address - Street 1:601 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08629-1915
Mailing Address - Country:US
Mailing Address - Phone:609-599-5000
Mailing Address - Fax:
Practice Address - Street 1:601 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08629-1915
Practice Address - Country:US
Practice Address - Phone:609-599-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11105282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
0546244OtherAETNA HMO
20844OtherUNIVERSITY HEALTH PLAN
310021OtherAARP
NJ310021OtherHORIZON
NJ41366058Medicaid
NJ1016318OtherHORIZON NJ HEALTH
50053OtherAMERIGROUP
1000191700OtherAMERICHOICE
PA300795OtherKEYSTONE
310021OtherBLUE CROSS
IL5506OtherPHS MEDICAID
0546211OtherAETNA LIFE
PA18653260002OtherPA MEDICAID
300795OtherAMERIHEALTH
PA1237OtherIBC
310021OtherMAIL HANDLERS
H03064OtherOXFORD
310021OtherMAGNET
NJ41366058Medicaid
310021OtherBLUE CROSS