Provider Demographics
NPI:1316924236
Name:ST VINCENT INFIRMARY MEDICAL CENTER
Entity type:Organization
Organization Name:ST VINCENT INFIRMARY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-664-4933
Mailing Address - Street 1:2 SAINT VINCENT CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5423
Mailing Address - Country:US
Mailing Address - Phone:501-664-4933
Mailing Address - Fax:501-552-4235
Practice Address - Street 1:2 SAINT VINCENT CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5423
Practice Address - Country:US
Practice Address - Phone:501-664-4933
Practice Address - Fax:501-552-4235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARAR4096OtherARK STATE BOARD OF HEALTH