Basic Information
Provider Information
NPI: 1023418035
EntityType: 2
ReplacementNPI:  
OrganizationName: ST. FRANCIS HOSPITAL INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ST. FRANCIS CANCER CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8580 MAGELLAN PKWY
Address2:  
City: RICHMOND
State: VA
PostalCode: 232271149
CountryCode: US
TelephoneNumber: 8046275462
FaxNumber: 8664490896
Practice Location
Address1: 104 INNOVATION DR
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296075253
CountryCode: US
TelephoneNumber: 8646036200
FaxNumber: 8646036141
Other Information
ProviderEnumerationDate: 08/27/2014
LastUpdateDate: 06/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCCULLOCH
AuthorizedOfficialFirstName: RAYMOND
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CONTROLLER
AuthorizedOfficialTelephone: 8642824910
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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