Individual ProviderAhmad AlhaririInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701(260) 266-2020PECOS EnrollmentBased on the most recent information from CMS, provider Ahmad Alhariri is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1003121930Provider TypeIndividualFull NameAlhariri, AhmadCredentialMDGenderMaleSole ProprietorYesEnumeration Date8/16/2010Last Updated11/8/2024Contact InformationPractice LocationPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701Phone(260) 266-2020FaxUnlisted FaxMailing LocationMailing AddressProvider Enrollment 41 Mall Road, Burlington, MA 01805-0001PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense295429MassachusettsCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense01079155AIndianaCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicense295429MassachusettsCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense2010021662Missouri