MEDICARE: ST FRANCIS PHYSICIAN SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1578222790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST FRANCIS PHYSICIAN SERVICES INC

Provider Business Mailing Address
First Line	:	8580 MAGELLAN PKWY
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-1149
Country	:	US
Telephone Number	:
Fax Number	:	866-449-0896

Provider Business Practice Location Address
First Line	:	317 SAINT FRANCIS DR STE 250
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-3968
Country	:	US
Telephone Number	:	864-255-1449
Fax Number	:	864-675-8967

Authorized Official
Title or Position	:	CFO
Name	:	WILBUR GAY
Credential	:
Telephone Number	:	864-605-3762

Provider Enumeration Date	:	12/15/2021
Last Update Date	:	12/15/2021

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Directions to “ST FRANCIS PHYSICIAN SERVICES INC ” Practice Location

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