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General NPI Number Information
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NPI Number | 1508950171
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Entity Type | Organization
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Legal Business Name | PARKVIEW PROFESSIONAL PROGRAMS, INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 11109 PARKVIEW PLAZA DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone | 260-373-9420
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Fax | 260-373-9464
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Provider Business Mailing Address
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Address Line | PO BOX 5600
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City | FORT WAYNE
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State | IN
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Zip | 46895-5600
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Country | US
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Telephone | 260-373-7008
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Fax | 260-373-7059
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Authorized Official
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Title or Position | EXECUTIVE VP -- CFO
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Name | MR. MIKE BROWNING
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Credential |
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Telephone | 260-373-8407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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