Healthcare Provider Details

I. General information

NPI: 1750925921
Provider Name (Legal Business Name): PUTNAM COUNTY EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 S BLOOMINGTON ST
GREENCASTLE IN
46135-2113
US

IV. Provider business mailing address

PO BOX 56002
INDIANAPOLIS IN
46256-0002
US

V. Phone/Fax

Practice location:
  • Phone: 765-655-4121
  • Fax:
Mailing address:
  • Phone: 317-775-6753
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY JOSEPH TAYLOR
Title or Position: DEPUTY CHIEF
Credential: MPH, NRP, PI
Phone: 765-653-3600