Individual ProviderSarah WeaverNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1234 E Dupont Rd Ste 3, Fort Wayne, IN 46825-1545(260) 672-6590PECOS EnrollmentBased on the most recent information from CMS, provider Sarah Weaver is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1629440193Provider TypeIndividualFull NameWeaver, SarahGenderFemaleSole ProprietorNoEnumeration Date10/23/2015Last Updated10/7/2022Contact InformationPractice LocationPractice Address1234 E Dupont Rd Ste 3, Fort Wayne, IN 46825-1545Phone(260) 672-6590Fax(260) 672-6599Mailing LocationMailing Address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71005930AIndiana