Organization
IMAGI, LLC
Active
Other names
Northeast Indiana Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY D STEELE CHBC (ADMINISTRATOR)
(260) 969-7100
Entity
Organization
Contact information
Practice address
7900 W JEFFERSON BLVD, SUITE 202, FORT WAYNE, IN 46804-4128
(260) 969-7100
(260) 969-7182
Mailing address
7900 W JEFFERSON BLVD, SUITE 202, FORT WAYNE, IN 46804-4128
(260) 969-7100
(260) 969-7182
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210095
ANTHEM IDENTIFICATION NUM
IN
Enumeration date
07/02/2006
Last updated
08/22/2020
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