Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
CAREFIRST OF FORTWAYNE INC
Active
Organization
CAREFIRST OF FORTWAYNE INC
Active
Other names
Advanced Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL EDWARD JOHNSON RRT (PRESIDENT)
(260) 373-1600
Entity
Organization
Contact information
Practice address
718 N WAYNE ST, ANGOLA, IN 46703-1006
(260) 624-3093
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
69000127A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69000127A
PHARMACY LICENSE
IN
Enumeration date
08/06/2007
Last updated
11/15/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up