Healthcare Provider Details

I. General information

NPI: 1275305344
Provider Name (Legal Business Name): PARKVIEW HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8202 GLENCARIN BLVD
FORT WAYNE IN
46804
US

IV. Provider business mailing address

1450 PRODUCTION RD
FORT WAYNE IN
46808-1167
US

V. Phone/Fax

Practice location:
  • Phone: 260-425-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: STANTON RISSER
Title or Position: ACFO
Credential:
Phone: 260-266-9380