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General NPI Number Information
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NPI Number | 1538430913
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Entity Type | Organization
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Legal Business Name | FLORENCE HOSPITAL LLC
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 450 W ADAMSVILLE RD
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City | FLORENCE
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State | AZ
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Zip | 85132-8582
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Country | US
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Telephone | 520-868-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1547
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City | SEDALIA
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State | MO
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Zip | 65302-1547
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Country | US
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Telephone | 660-826-5960
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Fax | 660-826-4852
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Authorized Official
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Title or Position | CEO
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Name | GARY FAULKNER
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Credential |
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Telephone | 520-868-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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