Healthcare Provider Details

I. General information

NPI: 1376598078
Provider Name (Legal Business Name): GRANT COUNTY AUDITOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 S GARTHWAITE RD
GAS CITY IN
46933-1155
US

IV. Provider business mailing address

401 S ADAMS ST
MARION IN
46953-2037
US

V. Phone/Fax

Practice location:
  • Phone: 765-674-6592
  • Fax: 765-674-7037
Mailing address:
  • Phone: 765-674-6592
  • Fax: 765-674-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0332
License Number StateIN

VIII. Authorized Official

Name: MRS. DAWN RENEE HARNESS
Title or Position: BILLING ADMINSTRATOR
Credential:
Phone: 765-674-6592