MEDICARE: MORRISTOWN-HANOVER TOWNSHIP FIRE AND EMERGENCY MEDICAL BOARD

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	341600000X	Ambulance

General Provider Information

NPI Number	:	1699468793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORRISTOWN-HANOVER TOWNSHIP FIRE AND EMERGENCY MEDICAL BOARD

Provider Business Mailing Address
First Line	:	PO BOX 50890
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-0890
Country	:	US
Telephone Number	:	317-849-6628
Fax Number	:	317-849-6632

Provider Business Practice Location Address
First Line	:	422 W MAIN ST
Second Line	:
City	:	MORRISTOWN
State	:	IN
Zip	:	46161-9745
Country	:	US
Telephone Number	:	317-775-6753
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	STEVEN DAVIS
Credential	:
Telephone Number	:	317-775-6753

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/21/2023

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