Healthcare Provider Details

I. General information

NPI: 1841330362
Provider Name (Legal Business Name): EATON EMERGENCY MEDICAL TECHNICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W INDIANA AVE
EATON IN
47338-8832
US

IV. Provider business mailing address

103 W INDIANA AVE PO BOX 414
EATON IN
47338-8832
US

V. Phone/Fax

Practice location:
  • Phone: 765-396-3748
  • Fax: 765-396-4427
Mailing address:
  • Phone: 765-396-3748
  • Fax: 765-396-4427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0289
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: WENDY SMITH
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 317-775-6753