Healthcare Provider Details

I. General information

NPI: 1154574135
Provider Name (Legal Business Name): UNITED EMERGENCY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9019 W 133RD AVE
CEDAR LAKE IN
46303-9200
US

IV. Provider business mailing address

PO BOX 591
CEDAR LAKE IN
46303-0591
US

V. Phone/Fax

Practice location:
  • Phone: 219-714-4000
  • Fax: 219-714-4000
Mailing address:
  • Phone: 219-714-4000
  • Fax: 219-714-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number1177
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1177
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JASON BLANKINSHIP
Title or Position: PARTNER / EMS DIRECTOR
Credential: NREMT-B
Phone: 219-714-4000