MEDICARE: AMBULANCE ENTERPRISES, INC D/B/A INDIANA EMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	0398	IN
2	341600000X	Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003812637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBULANCE ENTERPRISES, INC D/B/A INDIANA EMS

Provider Business Mailing Address
First Line	:	2816 W. SAMPLE ST.
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46619-3230
Country	:	US
Telephone Number	:	574-289-0725
Fax Number	:	579-289-4662

Provider Business Practice Location Address
First Line	:	2816 W. SAMPLE ST.
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46619-3230
Country	:	US
Telephone Number	:	574-289-0725
Fax Number	:	579-289-4662

Authorized Official
Title or Position	:	BILLING MGR.
Name	:	MS. ROBIN I. ROBERTS
Credential	:
Telephone Number	:	574-289-0725

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/04/2008

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Directions to “AMBULANCE ENTERPRISES, INC D/B/A INDIANA EMS ” Practice Location

Language	Start Address	Practice Location

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