Provider Demographics
NPI:1851144638
Name:PARKVIEW HOSPITAL, INC.
Entity Type:Organization
Organization Name:PARKVIEW HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:CHRIST
Authorized Official - Middle Name:
Authorized Official - Last Name:JELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:260-266-4403
Mailing Address - Street 1:1660 BROADWAY SUITE 165
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802
Mailing Address - Country:US
Mailing Address - Phone:260-266-9807
Mailing Address - Fax:260-266-9811
Practice Address - Street 1:1660 BROADWAY SUITE 165
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802
Practice Address - Country:US
Practice Address - Phone:260-266-9807
Practice Address - Fax:260-266-9811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKVIEW HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy