Healthcare Provider Details

I. General information

NPI: 1932438819
Provider Name (Legal Business Name): MADISON TOWNSHIP FIRE AND RESCUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 EAST WATER STREET
LINDEN IN
47955-0081
US

IV. Provider business mailing address

P O BOX 81 302 EAST WATER STREET
LINDEN IN
47955-0081
US

V. Phone/Fax

Practice location:
  • Phone: 765-339-4861
  • Fax: 765-339-4859
Mailing address:
  • Phone: 765-339-4861
  • Fax: 765-339-4859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number1063
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number343900000X
License Number StateIN

VIII. Authorized Official

Name: MR. FRED W HARSHMAN
Title or Position: FIRE CHIEF
Credential:
Phone: 765-339-4861