Healthcare Provider Details

I. General information

NPI: 1306970686
Provider Name (Legal Business Name): ST FRANCIS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 ST FRANCIS DR
BRECKENRIDGE MN
56520-1025
US

IV. Provider business mailing address

2400 ST FRANCIS DR
BRECKENRIDGE MN
56520-1025
US

V. Phone/Fax

Practice location:
  • Phone: 218-643-3000
  • Fax: 218-643-0855
Mailing address:
  • Phone: 218-643-3000
  • Fax: 218-643-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number261077-3
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. NANCY WHITNEY
Title or Position: CFO
Credential: CPA
Phone: 218-643-0402