Healthcare Provider Details

I. General information

NPI: 1801911094
Provider Name (Legal Business Name): LIZTON UNION TOWNSHIP HENDRICKS COUNTY INDIANA VOLUNTEER FIRE DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E. MAIN ST.
LIZTON IN
46149
US

IV. Provider business mailing address

PO BOX 502250
INDIANAPOLIS IN
46250-7250
US

V. Phone/Fax

Practice location:
  • Phone: 317-994-5400
  • Fax: 317-994-5761
Mailing address:
  • Phone: 317-849-6628
  • Fax: 317-849-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3416LO300X
License Number StateIN

VIII. Authorized Official

Name: NATHAN JOSEPH
Title or Position: ASSISTANT CHIEF
Credential:
Phone: 317-775-6753