Provider Demographics
NPI:1831391796
Name:ST FRANCIS VASCULAR ACCESS
Entity type:Organization
Organization Name:ST FRANCIS VASCULAR ACCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-327-7279
Mailing Address - Street 1:309 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7407
Mailing Address - Country:US
Mailing Address - Phone:318-327-7279
Mailing Address - Fax:
Practice Address - Street 1:309 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7407
Practice Address - Country:US
Practice Address - Phone:318-327-7279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST FRANCIS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-04
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center