Provider Demographics
NPI:1871736702
Name:FRANCISCAN HEALTH SYSTEM
Entity type:Organization
Organization Name:FRANCISCAN HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AMBULATORY PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-426-6209
Mailing Address - Street 1:PO BOX 31001-1489
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-1489
Mailing Address - Country:US
Mailing Address - Phone:253-530-2653
Mailing Address - Fax:253-530-2625
Practice Address - Street 1:11511 CANTERWOOD BLVD NW
Practice Address - Street 2:STE 220
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5813
Practice Address - Country:US
Practice Address - Phone:253-530-2066
Practice Address - Fax:253-530-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHARCF600786303336C0003X
WA600786303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2014986Medicaid
2119720OtherPK