| NPI | 1326058389 |
|---|---|
| Doing Business As | CARDIOSOM OF FORT WAYNE |
| Entity Type | Organization |
| Authorized Contact | JAY JARRELL President/COO 317-706-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IN 69000011A) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2010-08-10 |