Provider Demographics
NPI:1558501916
Name:ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-528-5910
Mailing Address - Street 1:1215 HADLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-2905
Mailing Address - Country:US
Mailing Address - Phone:317-834-9923
Mailing Address - Fax:317-834-9501
Practice Address - Street 1:1215 HADLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-2905
Practice Address - Country:US
Practice Address - Phone:317-834-9923
Practice Address - Fax:317-834-9501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF ST. FRANCIS HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-25
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200978570AMedicaid
IN15C0001168Medicare Oscar/Certification