Basic Information
| Provider Information | |||||||||
| NPI: | 1669628061 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SAINT FRANCIS HOSPITAL INC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | CARDIAC REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 707001 | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741707001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185028013 | ||||||||
| FaxNumber: | 9185028002 | ||||||||
| Practice Location | |||||||||
| Address1: | 6151 S YALE AVE | ||||||||
| Address2: | SUITE 101B | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741361907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185028013 | ||||||||
| FaxNumber: | 9185028002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2008 | ||||||||
| LastUpdateDate: | 08/18/2008 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | RENEE | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR,PATIENT FINANCIAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 9185028010 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SAINT FRANCIS HOSPITAL INC | ||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2262 | OK | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 010853406 | 05 | MO | MEDICAID | 108245105 | 05 | AR | MEDICAID | XHSP41145 | 05 | CA | MEDICAID | 100099860A | 05 | KS | MEDICAID | 100699570A | 05 | OK | MEDICAID | 871555600 | 05 | MN | MEDICAID | 126294 | 05 | AZ | MEDICAID | 0333660 | 05 | OH | MEDICAID | 0918540 | 05 | IA | MEDICAID | 100038950A | 05 | IN | MEDICAID | 100699570C | 05 | OK | MEDICAID | 174568900 | 01 | OK | US DEPT OF LABOR | OTHER | 000370091001 | 01 | OK | BCBS | OTHER | 00981255 | 05 | NY | MEDICAID | 40-4924046 | 05 | MI | MEDICAID | 010386322 | 05 | VA | MEDICAID | 072674701 | 05 | TX | MEDICAID | 094564100 | 05 | FL | MEDICAID | 1791148 | 05 | LA | MEDICAID | 30-4924037 | 05 | MI | MEDICAID | 95007951 | 05 | CO | MEDICAID | XHSP31145 | 05 | CA | MEDICAID |