Fort Wayne Medical Oncology & Hemat
Clinic Pharmacy
4402 E State Blvd, Fort Wayne
Indiana, 46815-6917
260-969-7846 260-483-1734
Fort Wayne Medical Oncology & Hemat is a Clinic Pharmacy in Fort Wayne, Indiana. It is located at 4402 E State Blvd, Fort Wayne and it's customer support contact number is 260-969-7846. The authorized person of Fort Wayne Medical Oncology & Hemat is Tracy Maravilla, PHARMD who is Pharmacy Director of the pharmacy and his contact number is 260-484-9660. Active license number of Fort Wayne Medical Oncology & Hemat is 60005894A for Clinic Pharmacy in Indiana.
Fort Wayne Medical Oncology & Hemat is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Pharmacy Details:
Fort Wayne Medical Oncology & Hemat type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Fort Wayne Medical Oncology & Hemat |
| Type: | Clinic Pharmacy |
| Location: | 4402 E State Blvd, Fort Wayne,
Indiana, 46815-6917 |
| Phone: | 260-969-7846 |
| Fax: | 260-483-1734 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Tracy Maravilla |
| Credentials: | PHARMD |
| Position: | Pharmacy Director |
| Contact Number: | 260-484-9660 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1215066949 |
| NPI Enumeration Date: | 06 Mar, 2007 |
| NPI Last Update On: | 03 May, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Fort Wayne Medical Oncology & Hemat are as mentioned below.
| Specialization | License Number | State | Status | |
| Clinic Pharmacy | 60005894A | Indiana | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 200544860A | Medicaid | Indiana | |
| 1560247 | Other | | Ncpdp Provider Identification Number |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 15099,
Fort Wayne, Indiana |
| Zip: | 46885-5099 |
| Phone Number: | -- |
Patients can reach Fort Wayne Medical Oncology & Hemat at
4402 E State Blvd, Fort Wayne, Indiana or can
call on customer care at 260-969-7846.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.