Provider Demographics
NPI:1124535000
Name:PARKVIEW WABASH HOSPITAL, INC.
Entity Type:Organization
Organization Name:PARKVIEW WABASH HOSPITAL, INC.
Other - Org Name:CASS STREET RHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-266-9313
Mailing Address - Street 1:1655 N CASS ST
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-9416
Mailing Address - Country:US
Mailing Address - Phone:260-569-2302
Mailing Address - Fax:
Practice Address - Street 1:1655 N CASS ST
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-9416
Practice Address - Country:US
Practice Address - Phone:260-569-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKVIEW WABASH HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health