Provider Demographics
NPI:1750924403
Name:FRANCISCAN BEACON HOSPITAL, LLC
Entity type:Organization
Organization Name:FRANCISCAN BEACON HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAFFETONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-647-1040
Mailing Address - Street 1:1010 W STATE ROAD 2
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-5465
Mailing Address - Country:US
Mailing Address - Phone:219-575-6700
Mailing Address - Fax:219-575-6699
Practice Address - Street 1:1010 W STATE ROAD 2
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-5465
Practice Address - Country:US
Practice Address - Phone:219-575-6700
Practice Address - Fax:219-575-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital