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General NPI Number Information
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NPI Number | 1245569144
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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 | 12/24/2009
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 1501 HARTFORD ST
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City | LAFAYETTE
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State | IN
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Zip | 47904-2134
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Country | US
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Telephone | 765-449-3152
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Fax | 765-449-3117
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Provider Business Mailing Address
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Address Line | 1501 HARTFORD ST
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City | LAFAYETTE
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State | IN
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Zip | 47904-2134
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Country | US
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Telephone | 765-423-6276
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Fax | 765-423-6049
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Authorized Official
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Title or Position | 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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0007
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License Number State | IN
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