Provider Demographics
NPI:1336154798
Name:ST FRANCIS PEDIATRIC AFTER HOURS CLINIC, LLC
Entity Type:Organization
Organization Name:ST FRANCIS PEDIATRIC AFTER HOURS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SR VP FINANCE SFMC
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-327-7369
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71210-0207
Mailing Address - Country:US
Mailing Address - Phone:318-327-7367
Mailing Address - Fax:
Practice Address - Street 1:920 OLIVER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5702
Practice Address - Country:US
Practice Address - Phone:318-327-7367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty