FORT WAYNE MEDICAL ONCOLOGY & HEMAT NPI 1215066949

NPI Information

FORT WAYNE MEDICAL ONCOLOGY & HEMAT is a clinic pharmacy pharmacy in Fort Wayne, IN. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. FORT WAYNE MEDICAL ONCOLOGY & HEMAT NPI is 1215066949. The provider is registered as an organization entity type.
The provider Is Doing Business As Ft Wayne Med Oncology And Hematology.

The provider's business location address is:

4402 E STATE BLVD
FORT WAYNE, IN
ZIP 46815-917
Phone: (260) 969-7846
Fax: (260) 483-1734

The provider's authorized official is Tracy Maravilla .
The authorized official title is Pharmacy Director and has the following contact phone number (260) 484-9660.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 5/3/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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