MEDICARE: CALIBER, LLC

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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1164881744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIBER, LLC

Provider Business Mailing Address
First Line	:	3201 STELLHORN RD
Second Line	:	SUITE A-143
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-4697
Country	:	US
Telephone Number	:	260-407-6491
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 STELLHORN RD
Second Line	:	SUITE A-143
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-4697
Country	:	US
Telephone Number	:	260-407-6491
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF COMPLIANCE & FINANCE
Name	:	MR. THOMAS S TALARICO
Credential	:	CPA
Telephone Number	:	260-407-6491

Provider Enumeration Date	:	02/11/2016
Last Update Date	:	02/11/2016

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