Provider Demographics
NPI:1528318987
Name:FRANCISCAN HEALTH OLYMPIA FIELDS
Entity type:Organization
Organization Name:FRANCISCAN HEALTH OLYMPIA FIELDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISIONAL CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-705-4530
Mailing Address - Street 1:7847 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1213
Mailing Address - Country:US
Mailing Address - Phone:800-848-2159
Mailing Address - Fax:708-331-3285
Practice Address - Street 1:7847 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1213
Practice Address - Country:US
Practice Address - Phone:855-383-7095
Practice Address - Fax:219-836-7524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN69001008A332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0289070006OtherPTAN