Provider Demographics
NPI:1922403930
Name:FRANCISCAN PHYSICIAN NETWORK
Entity Type:Organization
Organization Name:FRANCISCAN PHYSICIAN NETWORK
Other - Org Name:ONCOLOGY AND HEMATOLOGY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR AMBULATORY BILLING 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 1:123 2ND ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6705
Practice Address - Country:US
Practice Address - Phone:317-859-5252
Practice Address - Fax:317-859-5258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN6694010006Medicare NSC