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Organization
CAREFIRST OF FORT WAYNE INC.
Active
Organization
CAREFIRST OF FORT WAYNE INC.
Active
Other names
Advanced Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD B BECHERT (PRESIDENT)
(260) 373-1600
Entity
Organization
Contact information
Practice address
3204 CONGRESSIONAL PKWY, FORT WAYNE, IN 46808-4417
(260) 373-1600
(260) 373-1601
Mailing address
3204 CONGRESSIONAL PKWY, FORT WAYNE, IN 46808-4417
(260) 373-1600
(260) 373-1601
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200234680
—
IN
01
—
69000127A
STATE LICENSE NUMBER
IN
Enumeration date
05/23/2005
Last updated
12/15/2009
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