# QHG OF FORT WAYNE COMPANY LLC

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518909985
- **Authorized official:** DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-7626

## Contact information

- **Practice address:** 7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
- **Practice address phone:** (260) 435-7334
- **Mailing address:** 7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 02/27/2008