Provider Demographics
NPI:1215012828
Name:FRANCISCAN HEALTH DYER & HAMMOND
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH DYER & HAMMOND
Other - Org Name:FRANCISCAN HEALTH HAMMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO - NORTHWEST INDIANA
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MARC
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:219-932-2300
Mailing Address - Fax:219-852-2492
Practice Address - Street 1:24 JOLIET ST
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1705
Practice Address - Country:US
Practice Address - Phone:219-932-2300
Practice Address - Fax:219-852-2492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-005004-1273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8017Medicaid
IN100268750Medicaid
IN100268750Medicaid