Provider Demographics
NPI:1912964081
Name:ST VINCENT INFIRMARY MEDICAL CENTER
Entity Type:Organization
Organization Name:ST VINCENT INFIRMARY MEDICAL CENTER
Other - Org Name:ST VINCENT HEALTH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-552-3999
Mailing Address - Street 1:PO BOX 22720
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72221-2720
Mailing Address - Country:US
Mailing Address - Phone:501-224-1690
Mailing Address - Fax:501-224-1927
Practice Address - Street 1:2 SAINT VINCENT CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5423
Practice Address - Country:US
Practice Address - Phone:501-552-3999
Practice Address - Fax:501-552-4187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105393002Medicaid
AR57640Medicare ID - Type Unspecified