340B Drug Pricing Program Database


DSH150021BR Parkview Hospital (Active) - information as of 6/3/2025 12:04:11 PM

Main Details
Parkview Hospital
PVH Family Birthing-Observation Beds
Disproportionate Share Hospital
Yes
DSH150021BR
150021


Additional Details
Active
2/18/2016
4/1/2016
3/9/2016
8/15/2024

Contacts

Parkview Health System
Stanton Risser, Assoc Chief Financial Officer
(260) 266-9313

Parkview Health
Stephanie Dickmeyer, 340B Program Supervisor
(260) 266-4408

Addresses

2200 Randallia Drive
Fot Wayne, IN 46805-4638

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
IN100268480A1366407603
OH67232821366407603
MI 1366407603
Shipping Addresses

PARKVIEW REGIONAL MEDICAL CENTER PHARMACY
11109 Parkview Plaza Drive
fort wayne, IN 46845
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH150021AAChildDSHParkview HospitalPRMC WOMENS HEALTH / Rehab-Physical Therapy11104 Parkview Circle Dr STE 50Fort WayneINTerminated
DSH150021ABChildDSHPARKVIEW HOSPITALHOSPICE FORT WAYNE1900 Carew St. Ste 6Fort WayneINTerminated
DSH150021ACChildDSHPARKVIEW HOSPITALHOME CARE FORT WAYNE1900 Carew St. Ste 6Fort WayneINTerminated
DSH150021ADChildDSHParkview HospitalPVH Interventional Radiology2200 Randallia DriveFort WayneINActive
DSH150021AEChildDSHParkview HospitalPVH REHAB PEDS ST OP3439 Hobson RoadFort WayneINTerminated
DSH150021AFChildDSHParkview HospitalREHAB PEDS OT OP3439 Hobson RoadFORT WAYNEINTerminated
DSH150021AGChildDSHParkview HospitalPVH REHAB PEDS PT OP3439 Hobson RoadFORT WAYNEINTerminated
DSH150021AHChildDSHPARKVIEW HOSPITALRANDALLIA ECHO2231 Carew StFORT WAYNEINTerminated
DSH150021AJChildDSHParkview HospitalAnticoagulation clinic / ATU2231 CAREW STFort WayneINTerminated
DSH150021AKChildDSHParkview HospitalPVH REHAB / PHYSICAL THERAPY2200 Randallia DriveFort WayneINActive
DSH150021ALChildDSHParkview HospitalPVH RESPIRATORY2200 Randallia DriveFort WayneINActive
DSH150021AMChildDSHParkview HospitalFWNV1 CT3909 New Vision DriveFORT WAYNEINTerminated
DSH150021ANChildDSHParkview HospitalFWNV1 MRI3909 New Vision DriveFORT WAYNEINActive
DSH150021APChildDSHPARKVIEW HOSPITALFORT WAYNE MRI2110 Carew StFort WayneINTerminated
DSH150021AQChildDSHParkview HospitalPVH PREP/RECOVERY2200 Randallia DriveFort WayneINActive
DSH150021ARChildDSHParkview HospitalPBH INTERMEDIATE SERVICES1720 Beacon StreetFort WayneINTerminated
DSH150021ASChildDSHParkview HospitalPVH Treadmill Stress Test2200 Randallia DriveFort WayneINActive
DSH150021ATChildDSHParkview HospitalPVH Pulmonary Function Test2200 Randallia DriveFort WayneINActive
DSH150021AUChildDSHParkview HospitalPVH Rehab/Speech Therapy2200 Randallia DriveFort WayneINActive
DSH150021AVChildDSHParkview HospitalPVH Rehab/Occupational Therapy2200 Randallia DriveFort WayneINActive
DSH150021AWChildDSHParkview HospitalPVH Rehab/Physical Therapy2200 Randallia DriveFort WayneINTerminated
DSH150021AXChildDSHParkview HospitalPVH OP INFUSION-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021AYChildDSHParkview HospitalPVH EMERGENCY DEPARTMENT2200 Randallia DriveFort WayneINActive
DSH150021AZChildDSHPARKVIEW HOSPITALPRMC / Nuclear Medicine Outpatient Service Center11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BChildDSHParkview HospitalFWINV CT8028 CARNEGIE BLVD STE 700FORT WAYNEINTerminated
DSH150021BAChildDSHPARKVIEW HOSPITALPRMC / MRI Outpatient Services11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BBChildDSHPARKVIEW HOSPITALPVH Continuing Care Center2200 Randallia DriveFort WayneINTerminated
DSH150021BCChildDSHPARKVIEW HOSPITALCT Outpatient Services Center / CT11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BDChildDSHPARKVIEW HOSPITALParkview Regional Medical Center / Endoscopy11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BEChildDSHPARKVIEW HOSPITALParkview Regional Medical Center / Rehab-Speech Therapy11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BFChildDSHPARKVIEW HOSPITALParkview Regional Medical Center / Rehab-Occupational Therapy11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BGChildDSHPARKVIEW HOSPITALPARKVIEW REGIONAL MEDICAL CENTER REHAB / Physical Therapy11109 Parkview Plaza DriveFort WayneINTerminated
DSH150021BHChildDSHParkview HospitalFWINV ECHOCARDIOGRAPHY8028 Carnegie Blvd STE 700FORT WAYNEINTerminated
DSH150021BJChildDSHParkview HospitalPCI OP Infusion-Observation Beds11050 Parkview Circle Drive STE 3AFort WayneINActive
DSH150021BKChildDSHParkview HospitalPVH CAREW MEDSURG-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021BLChildDSHParkview HospitalPVH ICU-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021BMChildDSHParkview HospitalPVH Clinical Decision Unit2200 Randallia driveFort WayneINTerminated
DSH150021BNChildDSHParkview HospitalPVH Family Birthing Center Procedure-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021BPChildDSHPARKVIEW HOSPITALPVH Randallia MEDSURG2200 Randallia DriveFort WayneINTerminated
DSH150021BQChildDSHParkview HospitalPVH IV Team2200 Randallia DriveFort WayneINTerminated
DSH150021BRChildDSHParkview HospitalPVH Family Birthing-Observation Beds2200 Randallia DriveFot WayneINActive
DSH150021BSChildDSHParkview HospitalPVH Rehab Unit-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021BTChildDSHParkview HospitalPVH STATE MEDSURG-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021BUChildDSHParkview HospitalPRMC Center on Aging and Health11104 Parkview Circle Dr STE 40Fort WayneINTerminated
DSH150021BVChildDSHParkview HospitalPVH Bridgeways2200 Randallia DriveFort WayneINTerminated
DSH150021BWChildDSHParkview HospitalPBH Youth-Observation Beds1720 Beacon StreetFort WayneINActive
DSH150021BXChildDSHParkview HospitalPBH NORTH EAST SOUTH WEST-Observation Beds1720 Beacon StreetFort WayneINActive
DSH150021BYChildDSHParkview HospitalPBH Assessment Center1720 BEACON STREETFORT WAYNEINTerminated
DSH150021BZChildDSHParkview HospitalPRMC Ultrasound OSC11141 Parkview Plaza Drive STE 100Fort WayneINActive
DSH150021CChildDSHParkview HospitalPVH CV NUCLEAR MEDICINE2200 Randallia DriveFort WayneINActive
DSH150021CAChildDSHParkview HospitalPRMC Rapid Diagnostic Unit-Observation Beds11104 Parkview Circle Dr Suite 210Fort WayneINActive
DSH150021CBChildDSHParkview HospitalPVH CARDIAC REHAB2200 Randallia DriveFort WayneINActive
DSH150021CCChildDSHParkview HospitalPVH CHRONIC PAIN PARTIAL HOSPITALIZATION2200 Randallia DriveFort WayneINToBeTerminated
DSH150021CDChildDSHParkview HospitalPCI ULTRASOUND11050 Parkview Circle Drive STE 1CFORT WAYNEINActive
DSH150021CEChildDSHParkview HospitalPCI CT11050 Parkview Circle Drive STE 1Cfort wayneINActive
DSH150021CFChildDSHParkview HospitalPBH PHYSICAL THERAPY1720 BEACON STREETFORT WAYNEINTerminated
DSH150021CGChildDSHParkview HospitalPVH ULTRASOUND2200 Randallia DriveFORT WAYNEINActive
DSH150021CHChildDSHParkview HospitalPCI DIAGNOSTIC IMAGING11050 Parkview Circle DriveFORT WAYNEINTerminated
DSH150021CJChildDSHParkview HospitalPRMC PHI HEART FAILURE CLINIC11108 PARKVIEW CIRCLE DRFORT WAYNEINTerminated
DSH150021CKChildDSHParkview HospitalPBH REHAB/OCCUPATIONAL THERAPY1720 BEACON STREETFORT WAYNEINTerminated
DSH150021CLChildDSHParkview HospitalPRMC PREOP CLINIC OSC-Observation Beds11143 Parkview Plaza DriveFORT WAYNEINActive
DSH150021CMChildDSHParkview HospitalPVH HEART FAILURE CLINIC2200 Randallia DriveFORT WAYNEINTerminated
DSH150021CNChildDSHParkview HospitalPVH CATH LAB2200 Randallia DriveFORT WAYNEINToBeTerminated
DSH150021CPChildDSHParkview HospitalPVH SUPPORTIVE CARE UNIT2200 Randallia DriveFORT WAYNEINTerminated
DSH150021CQChildDSHParkview HospitalPVH SLEEP LAB2200 Randallia DriveFORT WAYNEINActive
DSH150021CRChildDSHParkview HospitalPVH INFECTIOUS DISEASE2231 CAREW STFORT WAYNEINActive
DSH150021CSChildDSHParkview HospitalPVH HOLTER MON AND EVENT RECORDING2200 Randallia DriveFORT WAYNEINTerminated
DSH150021CTChildDSHParkview HospitalPRMC EEG PEDS11123 PARKVIEW PLAZA DR STE 202FORT WAYNEINTerminated
DSH150021CUChildDSHParkview HospitalPRMC INFECTIOUS DISEASE11104 PARKVIEW CIRCLE DR STE 440FORT WAYNEINActive
DSH150021CVChildDSHParkview HospitalFWNV1 ULTRASOUND3909 NEW VISION DRIVEFORT WAYNEINActive
DSH150021CWChildDSHParkview HospitalPRMC ENDOSCOPY11104 PARKVIEW CIRCLE DR STE 220FORT WAYNEINActive
DSH150021CXChildDSHParkview HospitalPVH EEG2200 Randallia DriveFORT WAYNEINActive
DSH150021CYChildDSHParkview HospitalPREMIER SURGERY OPERATING ROOM11141 Parkview Plaza Drive STE 200FORT WAYNEINActive
DSH150021CZChildDSHParkview HospitalPCI MRI11050 Parkview Circle Drive STE 1CFORT WAYNEINActive
DSH150021DChildDSHParkview HospitalPVH CT2200 Randallia DriveFort WayneINActive
DSH150021DAChildDSHParkview HospitalPRMC ECHO PEDS11123 PARKVIEW PLAZA DR STE 202FORT WAYNEINActive
DSH150021DBChildDSHParkview HospitalPRMC PEDS OP INFUSION11123 PARKVIEW PLAZA DR STE 202FORT WAYNEINActive
DSH150021DCChildDSHParkview HospitalPVH DIAGNOSTIC IMAGING2200 Randallia DriveFORT WAYNEINTerminated
DSH150021DDChildDSHParkview HospitalPRMC DIAGNOSTIC IMAGING OSC11141 PARKVIEW PLAZA DRIVE STE 200FORT WAYNEINTerminated
DSH150021DEChildDSHParkview HospitalPBH NUTRITION1720 BEACON STREETFORT WAYNEINTerminated
DSH150021DFChildDSHParkview HospitalPCI MAMMOGRAPHY11050 Parkview Circle Drive STE 4AFORT WAYNEINActive
DSH150021DGChildDSHParkview HospitalPRMC RHEUMATOLOGY11143 Parkview Plaza Drive STE 200FORT WAYNEINActive
DSH150021DHChildDSHParkview HospitalPREMIER SURGERY PACU11141 PARKVIEW PLAZA DRIVE STE 200FORT WAYNEINActive
DSH150021DJChildDSHParkview HospitalPVH EKG2200 Randallia DriveFORT WAYNEINActive
DSH150021DKChildDSHParkview HospitalFWINV DIAGNOSTIC IMAGING8028 CARNEGIE BLVD STE 700FORT WAYNEINTerminated
DSH150021DLChildDSHParkview HospitalPRMC HOLTER MONITOR PEDS11123 PARKVIEW PLAZA DR STE 202FORT WAYNEINTerminated
DSH150021DMChildDSHParkview HospitalPREMIER SURGERY PREP/RECOVERY11141 PARKVIEW PLAZA DRIVE STE 200FORT WAYNEINActive
DSH150021DNChildDSHParkview HospitalPVH ENGLISH PROGRESSIVE-Observation Beds2200 Randallia DriveFORT WAYNEINActive
DSH150021DPChildDSHParkview HospitalFWNV1 DIAGNOSTIC IMAGING3909 NEW VISION DRFORT WAYNEINTerminated
DSH150021DQChildDSHParkview HospitalPVH 2 SURGICAL-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021DRChildDSHParkview HospitalPRMC EEG OSC11141 PARKVIEW PLAZA DRFort WayneINTerminated
DSH150021DSChildDSHParkview HospitalPRMC W & C ADVANCED PERINATAL CARE CENTER-Observation Beds11123 PARKVIEW PLAZA DR STE 204FORT WAYNEINActive
DSH150021DTChildDSHParkview HospitalPVH 4 Medical-Observation Beds2200 Randallia DriveFORT WAYNEINActive
DSH150021DUChildDSHParkview HospitalPVH MEDSURGE EXTENDED - MedSurge Extended2200 Randallia DriveFort WayneINTerminated
DSH150021DVChildDSHParkview HospitalPVH PULMONARY REHAB - Pulm Rehab2200 Randallia DriveFort WayneINActive
DSH150021DWChildDSHParkview HospitalPVH Ostomy Clinic - Clinic2200 Randallia DriveFort WayneINActive
DSH150021DXChildDSHParkview HospitalPVH 7 MEDICAL-Outpatient Observation Beds - Clinic2200 Randallia DriveFort WayneINTerminated
DSH150021DYChildDSHParkview HospitalPVH 5 MEDICAL-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021DZChildDSHParkview HospitalPVH SURGE MEDSURG EXTENDED-Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021EChildDSHParkview HospitalPVH NUCLEAR MEDICINE2200 Randallia DriveFort WayneINActive
DSH150021EAChildDSHParkview HospitalPVH Lab - Lab2200 Randallia DrFort WayneINTerminated
DSH150021EBChildDSHParkview HospitalPRMC Lab - OSC11141 Parkview Plaza DriveFort WayneINTerminated
DSH150021ECChildDSHParkview HospitalPARKVIEW REG MED CENTER LAB - PCI Lab11050 PARKVIEW CIRCLE DRFORT WAYNEINTerminated
DSH150021EDChildDSHParkview HospitalPRMC MRI OSC - Radiology11141 Parkview Plaza Drive STE 100Fort WayneINActive
DSH150021EEChildDSHParkview HospitalPRMC NUCLEAR MEDICINE OSC - Radiology11141 Parkview Plaza Drive STE 100Fort WayneINActive
DSH150021EFChildDSHParkview HospitalPRMC CT OSC - Radiology11141 Parkview Plaza Drive STE 100Fort WayneINActive
DSH150021EGChildDSHParkview HospitalFWNV1 DIAG IMAGING - Radiology3909 New Vision DrFort WayneINTerminated
DSH150021EHChildDSHParkview HospitalPRMC LAB WAUSEON 725 SHOOP - Lab725 S Shoop AveWauseonOHTerminated
DSH150021EJChildDSHParkview HospitalPBH IOP CD - Partial Hospitalization1720 Beacon StreetFort WayneINActive
DSH150021EKChildDSHParkview HospitalNORTH CLINTON 5110 LAB - Lab5110 N. ClintonFort WayneINTerminated
DSH150021ELChildDSHParkview HospitalFWINV PEDIATRIC ECHOCARDIOGRAPHY - Radiology8028 Carnegie Blvd, Suite 700Fort WayneINActive
DSH150021EMChildDSHParkview HospitalFWLM DIAG IMAGING - Radiology8911 Liberty Mills Rd, Ste 200Fort WayneINTerminated
DSH150021ENChildDSHParkview HospitalPRMC LAB MONTPELIER - Lab935 Snyder AveMontpelierOHTerminated
DSH150021EPChildDSHParkview HospitalNHMR DIAG IMAGING - Radiology1331 Minnich RoadNew HavenINTerminated
DSH150021EQChildDSHParkview HospitalPRMC EEG OP - Electroencephalography11104 Parkview Circle Dr Suite 040Fort WayneINActive
DSH150021ERChildDSHParkview HospitalPVH HOLTER MON AND EVENT RECORDING - Echocardiology2200 Randallia DriveFort WayneINActive
DSH150021ESChildDSHParkview HospitalPVH PULMONARY REHAB - Respiratory Therapy2200 Randallia DriveFort WayneINTerminated
DSH150021ETChildDSHParkview HospitalST JOE CTR LAB - Lab5693 YMCA Park Drive WestFort WayneINTerminated
DSH150021EUChildDSHParkview HospitalFWLM LAB - Lab8911 Liberty Mills Rd, Ste 200Fort WayneINTerminated
DSH150021EVChildDSHParkview HospitalCAREW MEDICAL PARK LAB - Lab1818 Carew StreetFort WayneINTerminated
DSH150021EWChildDSHParkview HospitalPBH IOP MH - Observation Beds1720 Beacon StreetFort WayneINActive
DSH150021EXChildDSHParkview HospitalFWNV1 LAB - Lab3909 New Vision DrFort WayneINTerminated
DSH150021EYChildDSHParkview HospitalPVH REHAB PEDS NUTRITION - Nutrition Support3439 Hobson RoadFort WayneINActive
DSH150021EZChildDSHParkview HospitalWAYNEDALE TEMPLE LAB - Lab8607 Temple Dr.Fort WayneINTerminated
DSH150021FChildDSHParkview HospitalPVH MRI2200 Randallia DriveFort WayneINActive
DSH150021FAChildDSHParkview HospitalPRMC LAB ARCHBOLD - Lab121 Westfield DrArchboldOHTerminated
DSH150021FBChildDSHParkview HospitalPARKVIEW NEUROSCIENCES MULTISPECIALTY CLINIC - Neuro Rehab11104 Parkview Circle Dr Suite 040Fort WayneINActive
DSH150021FCChildDSHParkview HospitalPVH 6 EAST - Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021FDChildDSHParkview HospitalPRMC DIABETES ED - Clinic11143 Parkview Plaza Dr, Suite 110Fort WayneINActive
DSH150021FEChildDSHParkview HospitalLIMA ROAD CLINIC LAB - Lab11055 Twin Creeks CoveFort WayneINTerminated
DSH150021FFChildDSHParkview HospitalPVH DIAG IMAGING - Radiology2200 Randallia DriveFort WayneINTerminated
DSH150021FGChildDSHParkview HospitalPRMC DIAG IMAGING OSC - Radiology11141 Parkview Plaza Drive,Entrance 3Fort WayneINTerminated
DSH150021FHChildDSHParkview HospitalPVH ED OUTPATIENTS - Emergency Infusion2200 Randallia DriveFort WayneINActive
DSH150021FJChildDSHParkview HospitalPRMC MOB2 OBGYN LAB - Lab11123 Parkview Plaza DrFort WayneINTerminated
DSH150021FKChildDSHParkview HospitalFWINV LAB - Lab8028 Carnegie Blvd, Suite 160Fort WayneINTerminated
DSH150021FLChildDSHParkview HospitalPRMC PEDS DEV CARE CENTER OSC - Clinic11141 Parkview Plaza Drive STE 210Fort WayneINActive
DSH150021FMChildDSHParkview HospitalGRABILL MAIN LAB - Lab13430 Main StreetGrabillINTerminated
DSH150021FNChildDSHParkview HospitalPVH 3 STATE - Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021FPChildDSHParkview HospitalFWINV DIAG IMAGING - Radiology8028 Carnegie Blvd, Suite 700Fort WayneINTerminated
DSH150021FQChildDSHParkview HospitalPCI DIAG IMAGING - Radiology11050 Parkview Circle, Entrance 12Fort WayneINTerminated
DSH150021FRChildDSHParkview HospitalPRMC LAB BRYAN - Lab442 West High StreetBryanOHTerminated
DSH150021FSChildDSHParkview HospitalNHMR LAB - Lab1331 Minnich RoadNew HavenINTerminated
DSH150021FTChildDSHParkview HospitalPRMC PEDIATRIC HEMATOLOGY ONCOLOGY - Observation Beds11104 Parkview Circle Dr Suite 050Fort WayneINActive
DSH150021FUChildDSHParkview HospitalPVH 6 SOUTH - Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021FVChildDSHParkview HospitalPRMC PEDIATRIC HEMATOLOGY ONCOLOGY INFUSION - Lab11104 Parkview Circle Dr Suite 050Fort WayneINActive
DSH150021FWChildDSHParkview HospitalPFCI ONC THORACIC LUNG - Oncology11050 Parkview CircleFort WayneINActive
DSH150021FXChildDSHParkview HospitalPSW PFCI UPPER AND LOWER GI - GASTROENTEROLOGY8202 GLENCARIN BLVDFort WayneINActive
DSH150021FYChildDSHParkview HospitalPSW MAMMOGRAPHY - IMAGING8202 GLENCARIN BLVDFort WayneINActive
DSH150021FZChildDSHParkview HospitalPFCI REHAB OT OP HOD - Oncology11050 Parkview CircleFort WayneINToBeTerminated
DSH150021GChildDSHPARKVIEW HOSPITALPVH EMERGENCY DEPT2200 Randallia DrFort WayneINTerminated
DSH150021GAChildDSHParkview HospitalPFCI PULMONOLOGY - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GBChildDSHParkview HospitalPSW DIAG IMAGING - IMAGING8202 GLENCARIN BLVDFort WayneINTerminated
DSH150021GCChildDSHParkview HospitalPSW RESPIRATORY - RESPIRATORY THERAPY8202 GLENCARIN BLVDFort WayneINActive
DSH150021GDChildDSHParkview HospitalPFCI ONC GENITOURINARY - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GEChildDSHParkview HospitalPRMC NEURO SURGERY - Neurology11104 PARKVIEW CIRCLE DR STE 110Fort WayneINActive
DSH150021GFChildDSHParkview HospitalGLENCARIN LAB - Laboratory8233 Glencarin BlvdFort WayneINTerminated
DSH150021GGChildDSHParkview HospitalPFCI ONC SARCOMA - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GHChildDSHParkview HospitalPSW ECHO - RADIOLOGY-DIAGNOSTIC8202 GLENCARIN BLVDFort WayneINActive
DSH150021GJChildDSHParkview HospitalPFCI ONC MEDICAL ONCOLOGY/HEMATOLOGY - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GKChildDSHParkview HospitalPRMC NEUROINTERVENTION - Neurology11104 PARKVIEW CIRCLE DR STE 110Fort WayneINActive
DSH150021GLChildDSHParkview HospitalPSW MRI - IMAGING8202 GLENCARIN BLVDFort WayneINActive
DSH150021GMChildDSHParkview HospitalPSW STRESS TREADMILL - RESPIRATORY THERAPY8202 GLENCARIN BLVDFort WayneINActive
DSH150021GNChildDSHParkview HospitalPSW ENDOCRINOLOGY - Endocrinology8202 GLENCARIN BLVDFort WayneINActive
DSH150021GPChildDSHParkview HospitalPSW CT - IMAGING8202 GLENCARIN BLVDFort WayneINActive
DSH150021GQChildDSHParkview HospitalPFCI ONC UPPER AND LOWER GI - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GRChildDSHParkview HospitalPRMC OSC Endocrinology - Endocrinology11141 PARKVIEW PLAZA DRIVE STE 310Fort WayneINActive
DSH150021GSChildDSHParkview HospitalPFCI REHAB ST OP - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GTChildDSHParkview HospitalPSW PFCI GYN - Oncology8202 GLENCARIN BLVDFort WayneINActive
DSH150021GUChildDSHParkview HospitalPFCI ONC GYN - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GVChildDSHParkview HospitalPSW RHEUMATOLOGY - RHEUMATOLOGY8202 GLENCARIN BLVDFort WayneINActive
DSH150021GWChildDSHParkview HospitalPSW PULMONARY FUNCTION TEST - RESPIRATORY THERAPY8202 GLENCARIN BLVDFort WayneINActive
DSH150021GXChildDSHParkview HospitalPFCI ONC HIGH RISK - Oncology11050 Parkview CircleFort WayneINActive
DSH150021GYChildDSHParkview HospitalPSW GI - GASTROENTEROLOGY8202 GLENCARIN BLVDFort WayneINActive
DSH150021GZChildDSHParkview HospitalPSW NEURO - Neurology8202 GLENCARIN BLVDFort WayneINActive
DSH150021HChildDSHParkview HospitalPVH PACU2200 Randallia DriveFort WayneINActive
DSH150021HAChildDSHParkview HospitalPSW ULTRASOUND - IMAGING8202 GLENCARIN BLVDFort WayneINActive
DSH150021HBChildDSHParkview HospitalELECTRIC WORKS LAB - Laboratory1660 Broadway St Suite 165Fort WayneINTerminated
DSH150021HCChildDSHParkview HospitalPSW EMERGENCY DEPT - EMERGENCY8202 GLENCARIN BLVDFort WayneINActive
DSH150021HDChildDSHParkview HospitalPSW SLEEP LAB - RESPIRATORY THERAPY8202 GLENCARIN BLVDFort WayneINActive
DSH150021HEChildDSHParkview HospitalPRMC Gastroenterology - GI11104 Parkview Circle Dr Suite 440Fort WayneINActive
DSH150021HFChildDSHParkview HospitalPSW EKG - RESPIRATORY THERAPY8202 GLENCARIN BLVDFort WayneINActive
DSH150021HGChildDSHParkview HospitalPSW PFCI MEDICAL ONCOLOGY/HEMATOLOGY - Oncology8202 GLENCARIN BLVDFort WayneINToBeTerminated
DSH150021HHChildDSHParkview HospitalPFCI ONC PALCARE - Oncology11050 Parkview CircleFort WayneINActive
DSH150021HJChildDSHParkview HospitalPRMC NEURO - Neurology11104 PARKVIEW CIRCLE DR STE 110Fort WayneINActive
DSH150021HKChildDSHParkview HospitalPFCI ONC BREAST - Oncology11050 Parkview CircleFort WayneINActive
DSH150021HLChildDSHParkview HospitalPFCI REHAB PT OP HOD - Oncology11050 Parkview CircleFort WayneINActive
DSH150021HMChildDSHParkview HospitalPSW LAB - Laboratory8202 GLENCARIN BLVDFort WayneINTerminated
DSH150021HNChildDSHParkview HospitalPSW PFCI BREAST - Oncology8202 GLENCARIN BLVDFort WayneINToBeTerminated
DSH150021HPChildDSHParkview HospitalPSW URO - UROLOGY8202 GLENCARIN BLVDFort WayneINActive
DSH150021HQChildDSHParkview HospitalPSW HOLTER MON AND EVENT REC - RESPIRATORY THERAPY8202 GLENCARIN BLVDFort WayneINActive
DSH150021HRChildDSHParkview HospitalPBH ASSESSMENT CENTER - Psychiatry1720 Beacon StreetFort WayneINActive
DSH150021HSChildDSHParkview HospitalPEDS NUTRITION DEV CARE CENTER - Nutrition11141 Parkview Plaza DrFort WayneINActive
DSH150021HTChildDSHParkview HospitalPRMC PEDS DEV CARE CENTER SPEECH THERAPY - Developmental and Behavioral Pediatrics11141 PARKVIEW PLAZA DRIVEFort WayneINActive
DSH150021HUChildDSHParkview HospitalPVH OR ENDO - General Surgery2200 Randallia DriveFort WayneINActive
DSH150021HVChildDSHParkview HospitalPVH PERFUSION - Operating Room2200 Randallia DriveFort WayneINActive
DSH150021HWChildDSHParkview HospitalPVH PREOP CLINIC - Pre-Admission Testing2200 Randallia DriveFort WayneINToBeTerminated
DSH150021HXChildDSHParkview HospitalPVH PREP/RECOVERY EXTENDED - EMERGENCY2200 Randallia DriveFort WayneINActive
DSH150021HYChildDSHParkview HospitalPVH REHAB PEDS OT OP - Occupational Therapy3439 Hobson RoadFort WayneINActive
DSH150021HZChildDSHParkview HospitalPVH REHAB PEDS PT OP - Physical Therapy3439 Hobson RoadFort WayneINActive
DSH150021JChildDSHParkview HospitalPVH FLOUROSCOPY2200 Randallia DriveFort WayneINActive
DSH150021JAChildDSHParkview HospitalPVH REHAB PEDS ST OP - Speech Therapy3439 Hobson RoadFort WayneINActive
DSH150021JBChildDSHParkview HospitalRUDISILL LAB - Laboratory1007 W. Rudisill BlvdFort WayneINTerminated
DSH150021JCChildDSHParkview HospitalPBH LAB - Laboratory1720 Beacon StreetFort WayneINTerminated
DSH150021JDChildDSHParkview HospitalNORTH CLINTON LAB - Laboratory5104 N. ClintonFort WayneINTerminated
DSH150021JEChildDSHParkview HospitalPRMC OSC PEDS LAB - Laboratory11141 Parkview Plaza Dr Ste 210Fort WayneINTerminated
DSH150021JFChildDSHParkview HospitalPRMC HOLTER MONITOR PEDS MP2 - Cardiology11123 Parkview Plaza Dr Ste 202Fort WayneINActive
DSH150021JGChildDSHParkview HospitalPRMC CANCER INSTITUTE LAB - Laboratory11104 Parkview Circle Dr.Fort WayneINTerminated
DSH150021JHChildDSHParkview HospitalPVH REHAB/Physical Therapy Outpatient - Physical Therapy2200 Randallia DriveFort WayneINActive
DSH150021JJChildDSHParkview HospitalPVH LAB PARKVIEW HEART INSTITUTE - Laboratory2200 Randallia DriveFort WayneINTerminated
DSH150021JKChildDSHParkview HospitalPVH REHAB/Occupational Therapy Outpatient - Occupational Therapy2200 Randallia DriveFort WayneINActive
DSH150021JLChildDSHParkview HospitalWOODLAND PLAZA WEIGHT MANAGEMENT - Weight Management1234 E DUPONT RD STE 1Fort WayneINTerminated
DSH150021JMChildDSHParkview HospitalPVH REHAB ST OP - Neuro Rehab2200 Randallia DriveFort WayneINActive
DSH150021JNChildDSHParkview HospitalPRMC 1ST FLOOR STRESS TREADMILL - Radioisotope11108 Parkview Circle DriveFort WayneINActive
DSH150021JPChildDSHParkview HospitalPRMC ULTRASOUND PHI - Radiology11108 Parkview Circle DriveFort WayneINActive
DSH150021JQChildDSHParkview HospitalPRMC 1ST FLOOR CV NUCLEAR MEDICINE - Radiology11108 Parkview Circle DriveFort WayneINActive
DSH150021JRChildDSHParkview HospitalWOODLAND PLAZA INFECTIOUS DISEASE - Infectious Disease1234 E DUPONT RD STE 5Fort WayneINActive
DSH150021JSChildDSHParkview HospitalPRMC PREMIER ENDO - Endoscopy11141 Parkview Plaza DriveFort WayneINActive
DSH150021JTChildDSHParkview HospitalPRMC 1ST FLOOR PHI ECHOCARDIOGRAPHY - Radiology11108 Parkview Circle DriveFort WayneINActive
DSH150021JVChildDSHParkview HospitalPSW AAI - Allergy and Asthma8202 GLENCARIN BLVDFort WayneINActive
DSH150021JWChildDSHParkview HospitalPVH CMMC - Anticoag2231 CAREW STFort WayneINActive
DSH150021JXChildDSHParkview HospitalPRMC AAI - Allergy and Asthma11104 PARKVIEW CIRCLE DR STE 10Fort WayneINActive
DSH150021JYChildDSHParkview HospitalPRMC PULMONOLOGY - Pulmonology11104 PARKVIEW CIRCLE DR STE 410Fort WayneINActive
DSH150021JZChildDSHParkview HospitalPVH REHAB UNIT 2-OBSERVATION BEDS - Rehab Observation Beds2200 Randallia DriveFort WayneINActive
DSH150021KChildDSHParkview HospitalPVH OPERATING ROOM2200 Randallia DriveFort WayneINActive
DSH150021LChildDSHParkview HospitalPVH WOUND CARE2200 Randallia DriveFort WayneINActive
DSH150021MChildDSHParkview HospitalPVH ENDOSCOPY2200 Randallia DriveFort WayneINActive
DSH150021NChildDSHParkview HospitalPVH NUTRITION2200 Randallia DriveFort WayneINActive
DSH150021PChildDSHPARKVIEW HOSPITALMedical Oncology 11143 Parkview Plaza DriveFort WayneINTerminated
DSH150021QChildDSHPARKVIEW HOSPITALRegional Cancer Center / cancer services11141 Parkview Plaza Dr., Ste 110Fort WayneINTerminated
DSH150021RChildDSHParkview HospitalPCI RADIATION ONC11050 Parkview Circle Drive STE 1AFort WayneINActive
DSH150021SChildDSHParkview HospitalPVH CENTER FOR WOUND HEALING2200 Randallia DriveFort WayneINActive
DSH150021TChildDSHParkview HospitalPCI GENETIC COUNSELING11050 Parkview Circle Drive STE 1DFort WayneINTerminated
DSH150021UChildDSHParkview HospitalPVH ECHOCARDIOGRAPHY2200 Randallia DriveFort WayneINActive
DSH150021VChildDSHParkview HospitalPVH DIALYSIS2200 Randallia DriveFort WayneINActive
DSH150021WChildDSHPARKVIEW HOSPITALPVH REHAB / Occupational Therapy2200 Randallia DrFort WayneINTerminated
DSH150021XChildDSHParkview HospitalREHAB PEDS NUTRITION3439 Hobson RoadFort WayneINTerminated
DSH150021YChildDSHPARKVIEW HOSPITALPVH REHAB / Speech Therapy2200 Randallia DrFort WayneINTerminated
DSH150021ZChildDSHParkview HospitalPVH DIABETES ED2200 Randallia DriveFort WayneINActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressUpdateChange RequestPARKVIEW REGIONAL MEDICAL CENTER PHARMACY 11109 Parkview Plaza Dr fort wayne, IN 46845PARKVIEW REGIONAL MEDICAL CENTER PHARMACY 11109 Parkview Plaza Drive fort wayne, IN 4684511/12/2024 8:43 AM
DetailsEntity SubnameUpdateChange RequestPVH Family BirthingPVH Family Birthing-Observation Beds11/12/2024 8:43 AM
DetailsLast Recertification DateUpdateRecertification8/16/2023 1:34:37 PM8/15/2024 2:31:20 PM8/15/2024 2:31 PM
ContactsAuthorizing OfficialUpdateChange RequestWickens, Jeanne CFO Parkview Health 2603738407Risser, Stanton Assoc Chief Financial Officer Parkview Health System 26026693137/29/2024 4:18 PM
ContactsSigned ByUpdateChange RequestRisser, Stanton VP Finance 2603738403Risser, Stanton Assoc Chief Financial Officer Parkview Health System 26026693137/29/2024 8:23 AM
DetailsLast Recertification DateUpdateRecertification9/7/2022 11:46:42 AM8/16/2023 1:34:37 PM8/16/2023 1:34 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/5/2023 8:46 AM
Medicaid BillingMedicaid: NumberInsertChange Request 67232827/5/2023 8:46 AM
Medicaid BillingMedicaid: StateInsertChange Request OH7/5/2023 8:46 AM
DetailsLast Recertification DateUpdateRecertification8/17/2021 9:12:01 AM9/7/2022 11:46:42 AM9/7/2022 11:46 AM
DetailsLast Recertification DateUpdateRecertification8/20/2020 6:01:53 PM8/17/2021 9:12:01 AM8/17/2021 9:12 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/4/2021 8:37 AM
Medicaid BillingMedicaid: NumberInsertChange Request 100268480A6/4/2021 8:37 AM
Medicaid BillingMedicaid: StateInsertChange Request IN6/4/2021 8:37 AM
Medicaid BillingNPI: NumberInsertChange Request 13664076036/4/2021 8:37 AM
Medicaid BillingNPI: StateInsertChange Request MI6/4/2021 8:37 AM
Medicaid BillingNPI: NumberInsertChange Request 13664076036/4/2021 8:37 AM
Medicaid BillingNPI: StateInsertChange Request OH6/4/2021 8:37 AM
Medicaid BillingNPI: NumberInsertChange Request 13664076036/4/2021 8:37 AM
Medicaid BillingNPI: StateInsertChange Request IN6/4/2021 8:37 AM
DetailsLast Recertification DateUpdateRecertification8/26/2019 7:37:23 AM8/20/2020 6:01:53 PM8/20/2020 6:01 PM
AddressesShipping AddressInsertRecertification PARKVIEW REGIONAL MEDICAL CENTER PHARMACY 11109 Parkview Plaza Dr fort wayne, IN 468458/26/2019 7:37 AM
AddressesShipping AddressDeleteRecertificationParkview Hospital 11109 Parkview Plaza Dr fort wayne, IN 46845 8/26/2019 7:37 AM
DetailsLast Recertification DateUpdateRecertification8/15/2018 5:34:44 PM8/26/2019 7:37:23 AM8/26/2019 7:37 AM
DetailsEntity NameUpdateChange RequestParkview Regional Medical CenterParkview Hospital7/18/2019 11:41 AM
DetailsEntity NameUpdateChange RequestPARKVIEW HOSPITALParkview Regional Medical Center7/16/2019 11:00 AM
ContactsPrimary ContactUpdateProfile Change RequestDickmeyer, Stephanie 340B Program Coordinator Parkview Health 2602664408Dickmeyer, Stephanie 340B Program Supervisor Parkview Health 26026644081/28/2019 7:57 AM
DetailsLast Recertification DateUpdateRecertification11/9/2017 6:51:07 PM8/15/2018 5:34:44 PM8/15/2018 5:34 PM
DetailsLast Recertification DateUpdateRecertification8/15/2016 12:00:00 AM11/9/2017 6:51:07 PM11/9/2017 6:51 PM
ContactsAuthorizing OfficialUpdate Wickens, Jeanne CFO 2603738407Wickens, Jeanne CFO Parkview Health 260373840710/10/2017 9:37 AM
ContactsPrimary ContactUpdate Dickmeyer, Stephanie 340B Program Coordinator 2602664408Dickmeyer, Stephanie 340B Program Coordinator Parkview Health 260266440810/4/2017 11:10 AM
ContactsAuthorizing OfficialInsert  Wickens, Jeanne CFO 26037384078/9/2017 12:48 PM
ContactsPrimary ContactInsert  Dickmeyer, Stephanie 340B Program Coordinator 26026644085/31/2017 2:55 PM
ContactsSigned ByInsert  Risser, Stanton VP Finance 26037384035/23/2017 11:49 AM
AddressesMain AddressInsert   2200 Randallia Drive Fot Wayne, IN 46805-46388/15/2016 12:34 PM
AddressesShipping AddressInsert  Parkview Hospital 11109 Parkview Plaza Dr fort wayne, IN 468458/15/2016 12:34 PM
DetailsLast Recertification DateUpdate  8/15/2016 12:00:00 AM8/15/2016 12:34 PM
DatesParticipating Approval DateUpdate  3/9/2016 12:00:00 AM3/9/2016 12:22 PM
DetailsStateUpdate PendingActive3/9/2016 12:22 PM
DatesStart DateUpdate  4/1/2016 12:00:00 AM3/9/2016 12:22 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REG_58572DSH150021BR2/19/2016 11:10 AM
Details340B IDUpdate  OUTPATIENT_ONLINE_REG_585722/18/2016 4:57 PM
DetailsLast Recertification DateInsert   2/18/2016 4:57 PM
DetailsGrant NumberInsert   2/18/2016 4:57 PM
Details340B IDInsert   2/18/2016 4:57 PM
DetailsIs Authorizing Official EHB DataInsert   2/18/2016 4:57 PM
DatesLast Date That 340B Drugs PurchasedInsert   2/18/2016 4:57 PM
DetailsMedicare Provider NumberInsert  1500212/18/2016 4:57 PM
DetailsEntity NameInsert  PARKVIEW HOSPITAL2/18/2016 4:57 PM
DetailsProgram CodeInsert  DSH2/18/2016 4:57 PM
DetailsEntity SubnameInsert  PVH Family Birthing2/18/2016 4:57 PM
DatesParticipating Approval DateInsert   2/18/2016 4:57 PM
DetailsStateInsert  Pending2/18/2016 4:57 PM
DatesRegistration DateInsert  2/18/2016 12:00:00 AM2/18/2016 4:57 PM
DatesSigned By DateInsert  2/18/2016 12:00:00 AM2/18/2016 4:57 PM
DatesStart DateInsert   2/18/2016 4:57 PM
TerminationsTermination CommentsInsert   2/18/2016 4:57 PM
TerminationsTermination DateInsert   2/18/2016 4:57 PM
TerminationsTermination Effective DateInsert   2/18/2016 4:57 PM
TerminationsTermination ReasonInsert   2/18/2016 4:57 PM