Healthcare Provider Details

I. General information

NPI: 1356246359
Provider Name (Legal Business Name): IOM HEALTH SYSTEM LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7631 W JEFFERSON BLVD
FORT WAYNE IN
46804-4133
US

IV. Provider business mailing address

7950 W JEFFERSON BLVD
FORT WAYNE IN
46804-4140
US

V. Phone/Fax

Practice location:
  • Phone: 260-436-7770
  • Fax: 260-436-3570
Mailing address:
  • Phone: 260-435-7001
  • Fax: 260-435-7632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 629-215-3953