Healthcare Provider Details

I. General information

NPI: 1245259878
Provider Name (Legal Business Name): PARKVIEW WABASH HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 JOHN KISSINGER DRIVE
WABASH IN
46992-1648
US

IV. Provider business mailing address

10501 CORPORATE DR
FORT WAYNE IN
46845-1700
US

V. Phone/Fax

Practice location:
  • Phone: 260-563-3131
  • Fax:
Mailing address:
  • Phone: 260-373-8406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number06-005094-1
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number14-005094-1
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number18-005094-1
License Number StateIN

VIII. Authorized Official

Name: MRS. JESSICA LEE-HANSEN
Title or Position: CFO
Credential:
Phone: 312-388-0125