Basic Information
| Provider Information | |||||||||
| NPI: | 1235306648 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. FRANCIS RADIOLOGISTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9263 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319089263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063202773 | ||||||||
| FaxNumber: | 7063216863 | ||||||||
| Practice Location | |||||||||
| Address1: | 2122 MANCHESTER EXPY | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319046878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063202773 | ||||||||
| FaxNumber: | 7063216863 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2008 | ||||||||
| LastUpdateDate: | 04/28/2015 | ||||||||
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| AuthorizedOfficialLastName: | HEMBREE | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO/SVP | ||||||||
| AuthorizedOfficialTelephone: | 7063203751 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 003135226A | 05 | GA | MEDICAID | 148218 | 05 | AL | MEDICAID |