MEDICARE: ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558501916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	1215 HADLEY RD
Second Line	:	SUITE 100
City	:	MOORESVILLE
State	:	IN
Zip	:	46158-2905
Country	:	US
Telephone Number	:	317-834-9923
Fax Number	:	317-834-9501

Provider Business Practice Location Address
First Line	:	1215 HADLEY RD
Second Line	:	SUITE 100
City	:	MOORESVILLE
State	:	IN
Zip	:	46158-2905
Country	:	US
Telephone Number	:	317-834-9923
Fax Number	:	317-834-9501

Authorized Official
Title or Position	:	CEO
Name	:	CHANDLER SHIRER
Credential	:
Telephone Number	:	317-528-5910

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	06/05/2020

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