Healthcare Provider Details

I. General information

NPI: 1679678197
Provider Name (Legal Business Name): FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HADLEY RD
MOORESVILLE IN
46158-1737
US

IV. Provider business mailing address

PO BOX 781008
DETROIT MI
48278-1008
US

V. Phone/Fax

Practice location:
  • Phone: 317-528-8953
  • Fax: 317-528-6696
Mailing address:
  • Phone: 317-528-4800
  • Fax: 317-865-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number06-005052-1
License Number StateIN

VIII. Authorized Official

Name: AMY HERRON
Title or Position: DIVISIONAL CFO
Credential:
Phone: 317-528-6877