VA NORTHERN INDIANA HEALTH CARE SYSTEM NPI 1386028330

NPI Information

NPI: 1386028330
Provider Name: VA NORTHERN INDIANA HEALTH CARE SYSTEM
Classification: Clinic/Center - 261QV0200X
Entity Type: Organization

Specialization: VA

CLIA Number: 15D0988541

Address:
2121 LAKE AVE
FORT WAYNE, IN
ZIP 46805
Phone: (260) 426-5431
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VA NORTHERN INDIANA HEALTH CARE SYSTEM is a va clinic center in Fort Wayne, IN. VA NORTHERN INDIANA HEALTH CARE SYSTEM NPI is 1386028330. The provider is registered as an organization entity type.

The provider's business location address is:

2121 LAKE AVE
FORT WAYNE, IN
ZIP 46805-100
Phone: (260) 426-5431

The provider's authorized official is Richard Hayes .
The authorized official title is Credentialing Specialist and has the following contact phone number (260) 426-5431.

The CLIA number assigned to this NPI record is 15D0988541 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/18/2015 and was last updated on 7/18/2015.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QV0200X	Clinic/Center	VA	03233198	OHIO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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