Healthcare Provider Details

I. General information

NPI: 1265532915
Provider Name (Legal Business Name): FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 09/16/2016
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: 317-528-8133
  • Fax: 317-528-6696
Mailing address:
  • Phone: 317-528-8953
  • Fax: 317-528-6696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number06-005031-1
License Number StateIN

VIII. Authorized Official

Name: MR. KEITH LAUTER
Title or Position: CFO
Credential: CPA
Phone: 317-528-8953