NPI 1023432192 · live from the CMS NPI Registry
Act 3 Care LLC
Family Medicine, Geriatric Medicine in Fort Wayne, IN. National Provider Identifier 1023432192, active.
NPI record
| NPI | 1023432192 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine, Geriatric Medicine 207QG0300X |
| Practice location | 7309 Trier Rd, Fort Wayne, IN 46815 |
| Practice phone | 260-515-3275 |
| Enumerated | February 10, 2014 |
| Last updated | July 18, 2023 |
| Authorized official | Shannon Pace, Office Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Geriatric Medicine | 207RG0300X | — |
| Family Medicine, Geriatric Medicine primary | 207QG0300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.