Basic Information
| Provider Information | |||||||||
| NPI: | 1235351602 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5600 | ||||||||
| Address2: | |||||||||
| City: | FORT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468955600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2603737008 | ||||||||
| FaxNumber: | 2603737059 | ||||||||
| Practice Location | |||||||||
| Address1: | 3103 E STATE BLVD | ||||||||
| Address2: | |||||||||
| City: | FORT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468054738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2603739300 | ||||||||
| FaxNumber: | 2603739301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 08/29/2007 | ||||||||
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| AuthorizedOfficialLastName: | NAFZIGER | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE VP -- CFO | ||||||||
| AuthorizedOfficialTelephone: | 2603737008 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0100X | Y | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine |
No ID Information.