Carefirst of Fortwayne INC

NPI #1306037254 in Angola, Indiana

Provider Information

NPI Number: 1306037254
Entity Type: Organization
Organization Name: Carefirst of Fortwayne INC
Primary Specialty: Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies
Enumeration Date: Aug 6, 2007
Last Updated: Nov 15, 2007

Practice Location

Address: 718 N WAYNE ST
City: Angola
State: Indiana
ZIP Code: 46703-1006
Phone: (260) 624-3093

Authorized Official

Name: MR. RUSSELL EDWARD JOHNSON, RRT
Title: PRESIDENT
Phone: (260) 373-1600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies	332BX2000X	Primary

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