Provider Demographics
NPI:1144603382
Name:FRANCISCAN HEALTH MUNSTER
Entity type:Organization
Organization Name:FRANCISCAN HEALTH MUNSTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-877-1410
Mailing Address - Street 1:7905 CALUMET AVE STE 1020
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2549
Mailing Address - Country:US
Mailing Address - Phone:219-852-1521
Mailing Address - Fax:219-852-1522
Practice Address - Street 1:7905 CALUMET AVE STE 1020
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2549
Practice Address - Country:US
Practice Address - Phone:219-852-1521
Practice Address - Fax:219-852-1522
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN HEALTH MUNSTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-07
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60351330472001Medicaid
IN201334160Medicaid