Provider Demographics
NPI:1083984132
Name:FRANCISCAN HEALTHCARE -MUNSTER
Entity Type:Organization
Organization Name:FRANCISCAN HEALTHCARE -MUNSTER
Other - Org Name:FRANCISCAN HEALTHCARE-MUNSTER- SLEEP CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARB
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-922-4207
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:219-836-7535
Mailing Address - Fax:219-836-7540
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:219-836-7535
Practice Address - Fax:219-836-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010676502084N0600X
IN0106765082084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200932940 CMedicaid
IN200932940 CMedicaid