Healthcare Provider Details

I. General information

NPI: 1114173507
Provider Name (Legal Business Name): FRANCISCAN PHYSICIANS HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SUPERIOR AVE
MUNSTER IN
46321-4037
US

IV. Provider business mailing address

PO BOX 162
DYER IN
46311-0162
US

V. Phone/Fax

Practice location:
  • Phone: 219-934-2085
  • Fax:
Mailing address:
  • Phone: 219-864-2107
  • Fax: 219-864-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BARBARA GREENE
Title or Position: PRESIDENT
Credential:
Phone: 219-934-2085