Provider Demographics
NPI:1902986904
Name:FRANCISCAN HEALTH SYSTEM
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH SYSTEM
Other - Org Name:FRANCISCAN PHARMACY AND HOME MEDICAL SUPPLY ST. JOSEPH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL CFO - NORTHWEST FHS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSACKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-641-5468
Mailing Address - Street 1:1608 S J ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4930
Mailing Address - Country:US
Mailing Address - Phone:253-426-6912
Mailing Address - Fax:253-538-4612
Practice Address - Street 1:1608 S J ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4930
Practice Address - Country:US
Practice Address - Phone:253-426-6912
Practice Address - Fax:253-538-4612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
WACF00004025333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6030241Medicaid
WA62150OtherL & I
WA6030241Medicaid