Provider Demographics
NPI: | 1861625709 |
---|---|
Name: | ST. FRANCIS HOSPITAL AND HEALTH CENTERS |
Entity type: | Organization |
Organization Name: | ST. FRANCIS HOSPITAL AND HEALTH CENTERS |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GLENN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LOOMIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 317-781-3604 |
Mailing Address - Street 1: | PO BOX 664056 |
Mailing Address - Street 2: | |
Mailing Address - City: | INDIANAPOLIS |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46266-4056 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 317-780-3333 |
Mailing Address - Fax: | 317-780-3345 |
Practice Address - Street 1: | 5255 E STOP 11 RD |
Practice Address - Street 2: | SUITE 250 |
Practice Address - City: | INDIANAPOLIS |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46237-6340 |
Practice Address - Country: | US |
Practice Address - Phone: | 317-781-7391 |
Practice Address - Fax: | 317-887-5637 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-08-26 |
Last Update Date: | 2009-08-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2086X0206X | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | Group - Multi-Specialty |