Provider Demographics
NPI:1700684594
Name:LUMINARY HOSPICE OF FORT WAYNE, LLC
Entity type:Organization
Organization Name:LUMINARY HOSPICE OF FORT WAYNE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-864-8820
Mailing Address - Street 1:421 E COOK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-3658
Mailing Address - Country:US
Mailing Address - Phone:260-267-7668
Mailing Address - Fax:
Practice Address - Street 1:421 E COOK RD STE 400
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-3658
Practice Address - Country:US
Practice Address - Phone:260-267-7668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUMINARY HOSPICE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-06
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based