Healthcare Provider Details

I. General information

NPI: 1518975069
Provider Name (Legal Business Name): PARKVIEW HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 RANDALLIA DR
FORT WAYNE IN
46805-4638
US

IV. Provider business mailing address

PO BOX 5600
FORT WAYNE IN
46895-5600
US

V. Phone/Fax

Practice location:
  • Phone: 260-373-4000
  • Fax: 260-373-8446
Mailing address:
  • Phone: 260-373-7008
  • Fax: 260-373-7059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateIN

VIII. Authorized Official

Name: MR. MARK NAFZIGER
Title or Position: EXECUTIVE VP -- CFO
Credential:
Phone: 260-373-7008