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General NPI Number Information
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NPI Number | 1114300340
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Entity Type | Organization
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Legal Business Name | FRANCISCAN HEALTH LAFAYETTE
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1701 S CREASY LN RM 1W70
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City | LAFAYETTE
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State | IN
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Zip | 47905-4972
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Country | US
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Telephone | 765-428-3550
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Fax | 765-428-3551
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Provider Business Mailing Address
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Address Line | 1701 S CREASY LN RM 1W70
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City | LAFAYETTE
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State | IN
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Zip | 47905-4972
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Country | US
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Telephone | 765-428-3550
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Fax | 765-428-3551
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | TERRANCE E WILSON
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Credential |
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Telephone | 765-502-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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