Healthcare Provider Details

I. General information

NPI: 1548567340
Provider Name (Legal Business Name): TOWN OF EDINBURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W 900 N
EDINBURGH IN
46124-9711
US

IV. Provider business mailing address

PO BOX 503024
INDIANAPOLIS IN
46250-8024
US

V. Phone/Fax

Practice location:
  • Phone: 812-526-3510
  • Fax:
Mailing address:
  • Phone: 317-849-6628
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0086
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MARY PATTERSON
Title or Position: DIRECTOR OF ADMIN
Credential:
Phone: 317-775-6753