Provider Demographics
NPI:1619034022
Name:ST. FRANCIS HOSPITAL
Entity Type:Organization
Organization Name:ST. FRANCIS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-783-8137
Mailing Address - Street 1:1600 ALBANY ST. ATTN MEDICAL STAFF OFFICE
Mailing Address - Street 2:ST. FRANCIS HOSPITAL
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107
Mailing Address - Country:US
Mailing Address - Phone:317-782-7046
Mailing Address - Fax:317-782-6922
Practice Address - Street 1:112 N 17TH AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:BEECH GROVE
Practice Address - State:IN
Practice Address - Zip Code:46107-1253
Practice Address - Country:US
Practice Address - Phone:317-782-7046
Practice Address - Fax:317-782-6922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35-091357302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
INE83519Medicare UPIN