Covered Entity Details

RRC150162-07 FRANCISCAN HEALTH INDIANAPOLIS (Approved) - information as of 5/23/2025 10:26:27 PM

Main Details

Name

FRANCISCAN HEALTH INDIANAPOLIS

Subdivision Name

Franciscan Health Rheumatology & Osteoporosis Specialists, a Department of Franciscan Health Indianapolis - IN RHEUMATOLOGY

Type

Rural Referral Center

Rural

Yes

340B ID

RRC150162-07

Medicare Provider Number

150162

Outpatient Facility Provider Number

Additional Details

Current Program Status

Approved

Registration Date

4/9/2025

Participating Start Date

7/1/2025

Participating Approval Date

5/9/2025

Last Recertification Date

Contacts

Authorizing Official

Franciscan Alliance
Amy Herron, Regional CFO
(317) 528-8470

Primary Contact

Franciscan Health
Laura Shondell, Administrative Director Medication Systems and Operations
(765) 423-6900

Addresses

Street Address

5255 E Stop 11 Rd STE 320
Indianapolis, IN 46237

Billing Address

Franciscan Health Indianapolis
8111 S. Emerson Avenue
Indianapolis, IN 46237

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
IN	200823020A	1386749893

Shipping Addresses

Shipping Address 1

Franciscan Health Rheumatology & Osteoporosis Specialists, a Dept of Franciscan Health Indianapolis
5255 E Stop 11 Rd STE 320
Indianapolis, IN 46237

Shipping Address 2

Franciscan Health Indianapolis
8111 S. Emerson Avenue
Indianapolis, IN 46237

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
RRC150162-01	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	Franciscan Health Carmel Oncology Hematology Specialists Infusion - Infusion	North Meridian Medical Pavillion	Carmel	IN	Active
RRC150162-02	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	Franciscan Health Indianapolis Nuclear Cardiology - IN IHP NUC DIAG	5255 E Stop 11 Rd, Suite 240	Indianapolis	IN	Active
RRC150162-03	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	FRANCISCAN HEALTH INDIANAPOLIS SPIN - IN SPINE CENTER	8051 S EMERSON AVE	INDIANAPOLIS	IN	Active
RRC150162-04	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	FRANCISCAN HEALTH INDIANAPOLIS CARD - Franciscan Health Indiana Heart Physicians, a department of Franciscan Health Indianapolis	5330 E STOP 11 RD	INDIANAPOLIS	IN	Active
RRC150162-05	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	Franciscan Health Infusion Center Mooresville, a department of Franciscan Health Indianapolis - Outpatient Infusion Services - Mooresville	1215 Hadley Road	Mooresville	IN	Active
RRC150162-06	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	Franciscan Health Diabetes & Endocrinology Specialists, a Department of Franciscan Health Indianapolis - IN Endocrinology	5230 E Stop 11 Rd STE 150	Indianapolis	IN	Approved
RRC150162-07	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	Franciscan Health Rheumatology & Osteoporosis Specialists, a Department of Franciscan Health Indianapolis - IN RHEUMATOLOGY	5255 E Stop 11 Rd STE 320	Indianapolis	IN	Approved
RRC150162-08	Child	RRC	FRANCISCAN HEALTH INDIANAPOLIS	Franciscan Health Oncology & Hematology Specialists Mooresville, a Department of Franciscan Health Indianapolis - IN MV ONCOLOGY CLINIC	1215 Hadley Rd STE 200A	Mooresville	IN	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Herron, Amy Regional CFO Franciscan Alliance 3175288470	5/9/2025 6:47 AM
Details	340B ID	Update	New Registration		RRC150162-07	5/9/2025 6:47 AM
Details	Entity Subname	Update	New Registration	Franciscan Health Rheumatology & Osteoporosis Specialists, a Department of Franciscan Health Indianapolis	Franciscan Health Rheumatology & Osteoporosis Specialists, a Department of Franciscan Health Indianapolis - IN RHEUMATOLOGY	5/9/2025 6:47 AM
Dates	Participating Approval Date	Update	New Registration		5/9/2025 6:47:43 AM	5/9/2025 6:47 AM
Details	State	Update	New Registration	Pending	Approved	5/9/2025 6:47 AM
Dates	Signed By Date	Update	New Registration		5/8/2025 5:30:17 PM	5/9/2025 6:47 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	5/9/2025 6:47 AM
Addresses	Main Address	Insert	New Registration		5255 E Stop 11 Rd STE 320 Indianapolis, IN 46237	4/9/2025 11:44 AM
Addresses	Billing Address	Insert	New Registration		Franciscan Health Indianapolis 8111 S. Emerson Avenue Indianapolis, IN 46237	4/9/2025 11:44 AM
Addresses	Shipping Address	Insert	New Registration		Franciscan Health Rheumatology & Osteoporosis Specialists, a Dept of Franciscan Health Indianapolis 5255 E Stop 11 Rd STE 320 Indianapolis, IN 46237	4/9/2025 11:44 AM
Addresses	Shipping Address	Insert	New Registration		Franciscan Health Indianapolis 8111 S. Emerson Avenue Indianapolis, IN 46237	4/9/2025 11:44 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/9/2025 11:44 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		200823020A	4/9/2025 11:44 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		IN	4/9/2025 11:44 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1386749893	4/9/2025 11:44 AM
Medicaid Billing	NPI: State	Insert	New Registration		IN	4/9/2025 11:44 AM
Contacts	Primary Contact	Insert	New Registration		Shondell, Laura Administrative Director Medication Systems and Operations Franciscan Health 7654236900	4/9/2025 11:44 AM
Contacts	Authorizing Official	Insert	New Registration		Herron, Amy Regional CFO Franciscan Alliance 3175288470	4/9/2025 11:44 AM
Details	Assistance Received From Date	Insert	New Registration			4/9/2025 11:44 AM
Details	Assistance Received To Date	Insert	New Registration			4/9/2025 11:44 AM
Details	Last Recertification Date	Insert	New Registration			4/9/2025 11:44 AM
Details	Grant Number	Insert	New Registration			4/9/2025 11:44 AM
Details	340B ID	Insert	New Registration			4/9/2025 11:44 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/9/2025 11:44 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/9/2025 11:44 AM
Details	Medicare Provider Number	Insert	New Registration		150162	4/9/2025 11:44 AM
Details	Entity Name	Insert	New Registration		FRANCISCAN HEALTH INDIANAPOLIS	4/9/2025 11:44 AM
Details	NOFO Number	Insert	New Registration			4/9/2025 11:44 AM
Details	Program Code	Insert	New Registration		RRC	4/9/2025 11:44 AM
Details	Entity Subname	Insert	New Registration		Franciscan Health Rheumatology & Osteoporosis Specialists, a Department of Franciscan Health Indianapolis	4/9/2025 11:44 AM
Dates	Participating Approval Date	Insert	New Registration			4/9/2025 11:44 AM
Details	State	Insert	New Registration		Pending	4/9/2025 11:44 AM
Dates	Registration Date	Insert	New Registration		4/9/2025 11:44:04 AM	4/9/2025 11:44 AM
Dates	Signed By Date	Insert	New Registration			4/9/2025 11:44 AM
Dates	Start Date	Insert	New Registration			4/9/2025 11:44 AM
Terminations	Termination Comments	Insert	New Registration			4/9/2025 11:44 AM
Terminations	Termination Date	Insert	New Registration			4/9/2025 11:44 AM
Terminations	Termination Effective Date	Insert	New Registration			4/9/2025 11:44 AM
Terminations	Termination Reason	Insert	New Registration			4/9/2025 11:44 AM