Healthcare Provider Details

I. General information

NPI: 1578679437
Provider Name (Legal Business Name): CITY OF CROWN POINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 N EAST ST
CROWN POINT IN
46307-4028
US

IV. Provider business mailing address

101 N EAST ST
CROWN POINT IN
46307-4027
US

V. Phone/Fax

Practice location:
  • Phone: 219-488-2374
  • Fax: 219-323-8606
Mailing address:
  • Phone: 219-488-2374
  • Fax: 219-662-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK BAUMGARDNER
Title or Position: FIRE CHIEF
Credential:
Phone: 219-662-3248