Provider Demographics
NPI:1851570261
Name:FRANKLIN-MCCALLISTER
Entity type:Organization
Organization Name:FRANKLIN-MCCALLISTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-956-4965
Mailing Address - Street 1:25 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:WHEATFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46392-7383
Mailing Address - Country:US
Mailing Address - Phone:219-956-4965
Mailing Address - Fax:219-956-4965
Practice Address - Street 1:25 S PEARL ST
Practice Address - Street 2:
Practice Address - City:WHEATFIELD
Practice Address - State:IN
Practice Address - Zip Code:46392
Practice Address - Country:US
Practice Address - Phone:219-956-4965
Practice Address - Fax:219-956-4965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN$$$$$$$$$OtherSSN