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1366407603

NPI Code Detail

MEDICARE: PARKVIEW HOSPITAL, INC.

MEDICARE: PARKVIEW HOSPITAL, 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
1	3336C0003X	Community/Retail Pharmacy
2	282N00000X	General Acute Care Hospital	060050201	IN
3	3336I0012X	Institutional Pharmacy
4	282N00000X	General Acute Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000097670	OTHER		ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1674	OTHER		PHP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	1507461	OTHER		NCPDP
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	000000001907	OTHER		MPLAN
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366407603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKVIEW HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	PO BOX 5600
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46895-5600
Country	:	US
Telephone Number	:	260-373-8406
Fax Number	:	260-373-8469

Provider Business Practice Location Address
First Line	:	11109 PARKVIEW PLAZA DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1701
Country	:	US
Telephone Number	:	260-266-1000
Fax Number	:	260-373-8446

Authorized Official
Title or Position	:	CFO
Name	:	MRS. JESSICA LEE-HANSEN
Credential	:
Telephone Number	:	312-388-0125

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	03/02/2026

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Directions to “PARKVIEW HOSPITAL, INC. ” Practice Location

Language	Start Address	Practice Location

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