Provider Demographics
NPI:1851774095
Name:FRANCISCAN HEALTH MICHIGAN CITY
Entity type:Organization
Organization Name:FRANCISCAN HEALTH MICHIGAN CITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-877-1410
Mailing Address - Street 1:3500 FRANCISCAN WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-0033
Mailing Address - Country:US
Mailing Address - Phone:219-878-8300
Mailing Address - Fax:219-878-8301
Practice Address - Street 1:3500 FRANCISCAN WAY FL 1
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-0021
Practice Address - Country:US
Practice Address - Phone:219-878-8300
Practice Address - Fax:219-878-8301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN HEALTH MICHIGAN CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-07
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201334460Medicaid