1952326977 NPI number — AMISUB (SFH), INC.

Table of content: (NPI 1952326977)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952326977 NPI number — AMISUB (SFH), INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMISUB (SFH), INC.
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:
ST. FRANCIS HOSPITAL
Provider Other Organization Name Type Code:
3
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:
1952326977
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 741274
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-1274
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-242-2002
Provider Business Mailing Address Fax Number:
504-365-2204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5959 PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38119-5200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-765-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
901-765-1000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  0000000111 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00220213 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 655481970 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1021 . This is a "TENNCARE TLC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 139978295A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 440183 . This is a "OMNICARE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 84407 . This is a "COVENTRY HEALTH CARE LOUI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 95086 . This is a "BETTER HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01621960 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 440183B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".
  • Identifier: SAI0183N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 216627 . This is a "COVENTRY HEALTH CARE LOUI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3151805 . This is a "TENNCARE SELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 912032700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1707511 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010157402 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107150105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0009457 . This is a "BCBS OF TENNESSEE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 121916900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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