Healthcare Provider Details

I. General information

NPI: 1649227364
Provider Name (Legal Business Name): BUCK CREEK TOWNSHIP HANCOCK COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5809 W AIRPORT BLVD
GREENFIELD IN
46140-9654
US

IV. Provider business mailing address

PO BOX 50890
INDIANAPOLIS IN
46250-0890
US

V. Phone/Fax

Practice location:
  • Phone: 317-353-3570
  • Fax:
Mailing address:
  • Phone: 317-849-6628
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE SIMUNEK
Title or Position: TRUSTEE
Credential:
Phone: 317-775-6753