Healthcare Provider Details

I. General information

NPI: 1518962109
Provider Name (Legal Business Name): PARKVIEW HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CAREW ST STE 6
FORT WAYNE IN
46805-4765
US

IV. Provider business mailing address

PO BOX 5600
FORT WAYNE IN
46895-5600
US

V. Phone/Fax

Practice location:
  • Phone: 260-373-9800
  • Fax: 260-373-9949
Mailing address:
  • Phone: 260-373-7008
  • Fax: 260-373-7059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number050083471
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JEANNE WICKENS
Title or Position: SVP/CFO
Credential:
Phone: 260-373-8407