Organization
FRANCISCAN HEALTH RENSSELAER, INC.
Active
Parent organization
FRANCISCAN HEALTH RENSSELAER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRANCISCAN HEALTH RENSSELAER
Authorized official
MR. TERRANCE E WILSON (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(765) 502-4440
Entity
Organization
Contact information
Practice address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234
Mailing address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
05-005072-2
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097884
BLUE CROSS ID
IN
05
—
0150078
—
TN
05
—
0175224
—
OH
05
—
0564195
—
IN
05
—
100269660A
—
IN
05
—
80536700
—
WI
05
—
909962000
—
FL
05
—
MEDICAID CARESOURCE
—
IN
Enumeration date
10/27/2006
Last updated
10/17/2016
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