Southerncare Fort Wayne

LBN: Southerncare, Inc.
Southerncare Fort Wayne is an health care organization with primary practice located at 7557 W Jefferson Blvd , Fort Wayne IN 46804-4131. The organization recently has only one registered license in Agencies / Hospice Care, Community Based, which is considered as the primary health care specialty. Southerncare, Inc. can be contacted via phone (260) 432-6075, or through Kleberg, Jessica via phone (704) 664-2876.

Contact Information

Primary practice address
7557 W Jefferson Blvd Fort Wayne IN 46804-4131
Phone: (260) 432-6075
Fax: (260) 432-1275
Website:
Map and Directions
Authorized official contact:
Name: Kleberg, Jessica
Phone: (704) 664-2876

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X 060025631 Indiana
Agencies / Hospice Care, Community Based 251G00000X 14-002563-1 Indiana

Profile Details

NPI number 1851331615
LBN Legal business name Southerncare, Inc.
DBA Doing business as Southerncare Fort Wayne
Authorized official Kleberg, Jessica
Entity Organization
Organization subpart 1 No
Enumeration date Jun 8th, 2006
Last updated May 16th, 2016 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851331615 NPPES
Indiana MEDICAID 200424070A

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