Ambervale LLC
Clinic/Center, Radiology in Fort Wayne, IN. Organization (NPI-2).
NPI number1487574604
StatusActive
Last updated in NPPESJul 17, 2026
Details
- NPI
- 1487574604
- Entity type
- Organization (NPI-2)
- Legal business name
- Ambervale LLC
- Organization subpart
- No
- Enumeration date
- Jul 17, 2026
- Certification date
- Jul 17, 2026
- Last updated
- Jul 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0200X | Clinic/Center, Radiology | – | – | Yes |
Practice location
5534 Saint Joe RdFort Wayne, IN 46835-3328
Phone 406-309-6462
Mailing address
5534 Saint Joe RdFort Wayne, IN 46835-3328
Phone 406-309-6462
Authorized official
Samee Ijaz
Owner
4063096462
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