Healthcare Provider Details

I. General information

NPI: 1275885568
Provider Name (Legal Business Name): FRANCISCAN ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 S EMERSON AVE
INDIANAPOLIS IN
46237-8601
US

IV. Provider business mailing address

8111 S EMERSON AVE
INDIANAPOLIS IN
46237-8601
US

V. Phone/Fax

Practice location:
  • Phone: 317-528-5000
  • Fax:
Mailing address:
  • Phone: 317-528-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number87000775A
License Number StateIN

VIII. Authorized Official

Name: MR. ROBERT BRODY
Title or Position: CEO
Credential:
Phone: 317-528-5000