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NPI Code Detail

MEDICARE: CAREFIRST OF FORT WAYNE INC.

MEDICARE: CAREFIRST OF FORT WAYNE INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BX2000XOxygen Equipment & Supplies (DME)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
269000127AOTHERINSTATE LICENSE NUMBER

General Provider Information

NPI Number : 1083617286
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAREFIRST OF FORT WAYNE INC.
Provider Business Mailing Address
First Line : 3204 CONGRESSIONAL PKWY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46808-4417
Country : US
Telephone Number : 260-373-1600
Fax Number : 260-373-1601
Provider Business Practice Location Address
First Line : 3204 CONGRESSIONAL PKWY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46808-4417
Country : US
Telephone Number : 260-373-1600
Fax Number : 260-373-1601
Authorized Official
Title or Position : PRESIDENT
Name : CHAD B BECHERT
Credential :
Telephone Number : 260-373-1600
Provider Enumeration Date : 05/23/2005
Last Update Date : 12/15/2009

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Directions to “CAREFIRST OF FORT WAYNE INC. ” Practice Location

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