Fawver Waldo Clinic Llp
LBN: Fawver Waldo Clinic Llp
Fawver Waldo Clinic Llp is an health care organization with primary practice located at 6920 Pointe Inverness Way Suite 250, Fort Wayne IN 46804-7926. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Adult Mental Health is the primary health care specialty.
Fawver Waldo Clinic Llp can be contacted via phone (260) 436-4060, or through Fawver, Jay D via phone (260) 436-4060.
Contact Information
Primary practice address
6920 Pointe Inverness Way Suite 250
Fort Wayne IN 46804-7926
Phone: (260) 436-4060
Fax: (260) 436-5713
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Adult Mental Health | 261QM0850X | ||
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X |
Profile Details
| NPI number | 1174536346 |
|---|---|
| LBN Legal business name | Fawver Waldo Clinic Llp |
| DBA Doing business as | |
| Authorized official | Fawver, Jay D Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 15th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174536346 | NPPES |
| Other | DD0871 | RR MEDICARE |
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