Provider Demographics
NPI:1144225491
Name:FRANCISCAN HEALTH DYER & HAMMOND
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH DYER & HAMMOND
Other - Org Name:FRANCISCAN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-932-2300
Mailing Address - Street 1:5454 HOHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1931
Mailing Address - Country:US
Mailing Address - Phone:219-933-6663
Mailing Address - Fax:219-933-2641
Practice Address - Street 1:5454 HOHMAN AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1931
Practice Address - Country:US
Practice Address - Phone:219-933-6663
Practice Address - Fax:219-933-2641
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN HEALTH DYER & HAMMOND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-14
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN04-0005322-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100265040AMedicaid
IN100265040AMedicaid