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Organization

FRANCISCAN LAKESHORE ASC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL MCCORMICK MD (PRESIDENT/CEO)
(219) 757-6104
Entity
Organization

Contact information

Practice address
12800 MISSISSIPPI PKWY, CROWN POINT, IN 46307-6900
(219) 662-5560
Mailing address
12800 MISSISSIPPI PKWY, PAVILION C, CROWN POINT, IN 46307-6900
(219) 757-6298

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
11/19/2019
Last updated
09/30/2021
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