Healthcare Provider Details

I. General information

NPI: 1629169362
Provider Name (Legal Business Name): ST FRANCIS AFFILIATED SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3744 WOODRUFF RD
COLUMBUS GA
31904-5601
US

IV. Provider business mailing address

3744 WOODRUFF RD
COLUMBUS GA
31904-5601
US

V. Phone/Fax

Practice location:
  • Phone: 706-324-2402
  • Fax: 706-324-1667
Mailing address:
  • Phone: 706-324-2402
  • Fax: 706-324-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number234173
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number234173
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number234173
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number244043
License Number StateGA

VIII. Authorized Official

Name: MR. MATTHEW ANTHONY MOORE
Title or Position: SR VICE PRESIDENT AND CFO
Credential:
Phone: 706-596-4000