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Organization
INDIANA UNIVERSITY
Active
Organization
INDIANA UNIVERSITY
Active
Parent organization
PURDUE UNIVERSITY
Other names
IU Fort Wayne Lafayette Street Family Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PURDUE UNIVERSITY
Authorized official
REBECCA E DIXON MBA, RRT (DIRECTOR OF PATIENT CARE SERVICES)
(317) 278-9059
Entity
Organization
Contact information
Practice address
2700 SOUTH LAFAYETTE STREET, FORT WAYNE, IN 46806
(260) 744-3000
Mailing address
2700 S LAFAYETTE STREET, SUITE 200, FORT WAYNE, IN 46806
(260) 481-0400
(765) 496-1227
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
—
—
Other
Enumeration date
06/06/2007
Last updated
07/12/2018
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