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RRC150162-02 FRANCISCAN HEALTH INDIANAPOLIS (Active)
Main Details
Name
FRANCISCAN HEALTH INDIANAPOLIS
Subdivision Name
Franciscan Health Indianapolis Nuclear Cardiology - IN IHP NUC DIAG
Type
Rural Referral Center
Rural
Yes
340B ID
RRC150162-02
Medicare Provider Number
150162
Outpatient Facility Provider Number
Contacts
Authorizing Official
Franciscan Alliance Inc.
Jay Brehm, CFO - Central Indiana
(317) 528-8953
Primary Contact
Franciscan Health
Laura Shondell, Administrative Director Medication Systems and Operations
(765) 423-6900
Additional Details
Current Program Status
Active
Registration Date
1/15/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/5/2024
Last Recertification Date
Addresses
Street Address
5255 E Stop 11 Rd, Suite 240
Indianapolis, IN 46237
Billing Address
Franciscan Health Indianapolis
8111 S. Emerson Avenue
Indianapolis, IN 46237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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