Provider Demographics
NPI:1760812812
Name:THE ENDOSCOPY CENTER AT ST. FRANCIS, LLC
Entity Type:Organization
Organization Name:THE ENDOSCOPY CENTER AT ST. FRANCIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ULERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-857-4024
Mailing Address - Street 1:8051 S EMERSON AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8051 S EMERSON AVE STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8635
Practice Address - Country:US
Practice Address - Phone:317-857-4024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1386643211OtherPTAN
IN1679570857OtherPTAN
IN1710984877OtherPTAN
IN1396946596OtherPTAN
IN1457554834OtherPTAN
IN1720085871OtherPTAN
IN1891792933OtherPTAN
IN1760488563OtherPTAN
IN1013914118OtherPTAN
IN1760489942OtherPTAN
IN1336264175OtherPTAN
IN1629152152OtherPTAN
IN1720243256OtherPTAN
IN1760489884OtherPTAN
IN1154327955OtherPTAN
IN1558368696OtherPTAN