Basic Information
| Provider Information | |||||||||
| NPI: | 1811326572 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. FRANCIS CENTER FOR DIGESTIVE DISEASES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 HAMILTON AVE | ||||||||
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| City: | TRENTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086291915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095995000 | ||||||||
| FaxNumber: | 6096954234 | ||||||||
| Practice Location | |||||||||
| Address1: | 2275 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | TRENTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086192643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098900200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2013 | ||||||||
| LastUpdateDate: | 11/04/2013 | ||||||||
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| AuthorizedOfficialLastName: | STEPHENSON | ||||||||
| AuthorizedOfficialFirstName: | CHRISTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | INTERIM PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 6095995018 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ST FRANCIS MEDICAL CENTER | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0800X | NJ | Y | Ambulatory Health Care Facilities | Clinic/Center | Endoscopy |
No ID Information.