Provider Demographics
NPI:1508164914
Name:PARKVIEW HOSPITAL, INC.
Entity Type:Organization
Organization Name:PARKVIEW HOSPITAL, INC.
Other - Org Name:DURABLE MEDICAL EQUIPMENT-BILLING PROVIDER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PACKNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-373-7001
Mailing Address - Street 1:10501 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1700
Mailing Address - Country:US
Mailing Address - Phone:260-373-8406
Mailing Address - Fax:
Practice Address - Street 1:2200 RANDALLIA DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-4638
Practice Address - Country:US
Practice Address - Phone:260-373-4000
Practice Address - Fax:260-373-8446
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKVIEW HEALTH SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-09
Last Update Date:2019-07-31
Deactivation Date:2019-04-24
Deactivation Code:
Reactivation Date:2019-07-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies