OrganizationActive
IV Hydration Vitamin Therapy LLC
NPI 1083322473 · Infusion Therapy Clinic/Center · Fort Wayne, IN
Provider details
- NPI number
- 1083322473
- Entity type
- Organization
- Primary specialty
- Infusion Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Andrea Fast, Manager(765) 730-2130
Specialties & taxonomies
Ambulatory Health Care Facilities
- Infusion Therapy Registered Nurse163WI0500X
Nursing Service Providers
- Emergency Medicine Physician207P00000X
Allopathic & Osteopathic Physicians
- Health Service Clinic/Center261QH0100X
Ambulatory Health Care Facilities
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
10020 Auburn Park Dr Ste a
Fort Wayne, IN 46825-2389
Phone: (260) 705-7457
Approximate (ZIP-level) locationGet directions
Mailing address
2624 Barry Knoll Way
Fort Wayne, IN 46845-1938
Additional practice locations (1)
- 10106 Dupont Circle Dr EFort Wayne, IN 46825-1638Phone: (260) 705-7547
Registry dates
- Enumerated
- 2022-11-14
- Last updated
- 2022-11-29
- Certified
- 2022-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.