# PARKVIEW KOSCIUSKO SURGERY ONE, LLC

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

## Provider details

- **NPI number:** 1790506376
- **Authorized official:** MRS. JESSICA LEE-HANSEN (CFO)
- **Authorized official phone:** (312) 388-0125

## Contact information

- **Practice address:** 335 E 200N, WARSAW, IN 46582-7855
- **Practice address phone:** (260) 266-6870
- **Mailing address:** 1450 PRODUCTION RD, FORT WAYNE, IN 46808-1167
- **Mailing address phone:** (260) 266-6870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2024
- **Last updated:** 07/22/2026