Organization
CARDIOSOM OF FT. WAYNE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN PAUL GREISL (PRESIDENT)
(317) 706-1080
Entity
Organization
Contact information
Practice address
1625 MAGNAVOX WAY, FT WAYNE, IN 46804-1535
(888) 857-5337
(260) 459-9247
Mailing address
615 W CARMEL DR, STE 100, CARMEL, IN 46032-5504
(317) 706-1080
(317) 706-1022
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
06/28/2005
Last updated
08/22/2020
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