1922305606 NPI number — ST FRANCIS COMMUNITY HOSPITAL

Table of content: (NPI 1922305606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922305606 NPI number — ST FRANCIS COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST FRANCIS COMMUNITY HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FRANCISCAN HEALTH SYSTEM
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922305606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 31001-1447
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91110-1447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-573-7143
Provider Business Mailing Address Fax Number:
253-573-7059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34515 9TH AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003-6761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-573-7143
Provider Business Practice Location Address Fax Number:
253-573-7059
Provider Enumeration Date:
02/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
KETUL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
253-680-4002

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H-201 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3300118 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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