Healthcare Provider Details

I. General information

NPI: 1982993341
Provider Name (Legal Business Name): ST FRANCIS PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E GREENVILLE ST
ANDERSON SC
29621-5535
US

IV. Provider business mailing address

PO BOX 25039
GREENVILLE SC
29616-0039
US

V. Phone/Fax

Practice location:
  • Phone: 864-224-5689
  • Fax: 864-225-2349
Mailing address:
  • Phone: 864-224-5689
  • Fax: 864-255-2349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERYL M FAIRLEY
Title or Position: VICE PRESIDENT NETWORK OPERATIONS
Credential:
Phone: 864-605-3755