Provider Demographics
NPI:1740616184
Name:FRANCISCAN PHYSICIAN NETWORK
Entity Type:Organization
Organization Name:FRANCISCAN PHYSICIAN NETWORK
Other - Org Name:FRANCISCAN IMMEDIATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR AMBULATORY BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-554-4548
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:14641 THATCHER LN
Practice Address - Street 2:SUITE E01
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1577
Practice Address - Country:US
Practice Address - Phone:317-564-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care