# PARKVIEW HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARKVIEW HOSPITAL, INC.
- **Other names:** Medical Park 11 Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942428420
- **Legal business name:** PARKVIEW HOSPITAL, INC.
- **Authorized official:** JEANNE WICKENS (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (260) 266-9313

## Contact information

- **Practice address:** 11104 PARKVIEW CIRCLE DRIVE, FORT WAYNE, IN 46845-1704
- **Practice address phone:** (260) 266-4545
- **Practice address fax:** (260) 266-4549
- **Mailing address:** 11104 PARKVIEW CIRCLE DRIVE, FORT WAYNE, IN 46845-1704
- **Mailing address phone:** (260) 266-4545
- **Mailing address fax:** (260) 266-4549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 60000294A | IN | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 07/16/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100470980A | — | IN |
| 01 | — | 1536119 | NCPDP | — |