MEDICARE: LONGE ENTERPRISES CORP

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1972848018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGE ENTERPRISES CORP

Provider Business Mailing Address
First Line	:	7625 SOUTHTOWN XING
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-2517
Country	:	US
Telephone Number	:	260-447-3583
Fax Number	:	260-441-8276

Provider Business Practice Location Address
First Line	:	7625 SOUTHTOWN XING
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-2517
Country	:	US
Telephone Number	:	260-447-3583
Fax Number	:	260-441-8276

Authorized Official
Title or Position	:	INSURANCE SPECIALIST
Name	:	CARRIE TRUEX
Credential	:
Telephone Number	:	260-484-0615

Provider Enumeration Date	:	11/30/2012
Last Update Date	:	07/23/2025

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Directions to “LONGE ENTERPRISES CORP ” Practice Location

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