Provider Demographics
NPI:1033284666
Name:FRANCISCAN HEALTH MICHIGAN CITY
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH MICHIGAN CITY
Other - Org Name:FRANCISCAN ST. ANTHONY HEALTH - MICHIGAN CITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO - NORTHERN INDIANA
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-877-1033
Mailing Address - Street 1:3500 FRANCISCAN WAY
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-0021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 FRANCISCAN WAY
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-0021
Practice Address - Country:US
Practice Address - Phone:219-877-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-005015-1273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100269360AMedicaid
IN15S015Medicare Oscar/Certification